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New technology improves diagnosis and access to treatment for blood cancer patients

PATIENTS with specific types of blood cancer (Non-Hodgkin lymphoma) could receive an improved and more accurate diagnosis through new genetic testing, allowing them access to promising new treatments according to research led by The Royal Marsden NHS Foundation Trust.

Results from this four-year multi-centre trial were presented at The American Society of Haematology (ASH) virtual conference recently which suggested vital benefits to using next-generation sequencing in patients with Non-Hodgkin lymphoma, who had previously not been given a specific malignancy category for their condition. Results were presented by Dr Matthew Cross, Clinical Research Fellow at The Royal Marsden, whose role is funded by The Royal Marsden Cancer Charity.

Dr Matthew Cross said:

“Previously, tests for Non-Hodgkin lymphoma have only been able to look at one gene at a time to explore mutations but by using next generation sequencing technology, researchers in this trial analysed up to 70 different genes at the same time to identify multiple mutations relevant to the patient’s diagnosis. Identifying these genetic changes can be key to assigning a specific category in certain Non-Hodgkin Lymphomas which then leads to a range of new targeted treatments becoming accessible for the patient.”

Over 100 patients were enrolled in the ENABLE-NGS trial across 14 different UK centres and blood samples were obtained for analysis through the next generation sequencing process at The Royal Marsden. Using innovative testing equipment in state-of-the-art laboratories, researchers were able to extract and fragment tumour DNA from blood samples to identify gene mutations in order to give a more accurate diagnosis and tailor treatment accordingly. The technology used in the next-generation sequencing by the molecular diagnostics team included the latest DNA sequencing machine, the NovaSeq 6000, funded thanks to a generous donation of £1 million from the Denise Coates Foundation to The Royal Marsden Cancer Charity.

Dr Sunil Iyengar, Consultant Haematologist at The Royal Marsden who led the ENABLE-NGS trial, said:

“Using this new cutting-edge technology means we are able to look at the genetics of cancer cells in patients more efficiently, exploring multiple genetic changes at the same time to find abnormalities that could inform treatment choice or potentially be targeted for treatment. Being able to enhance a diagnosis by assigning a specific category of malignancy in patients with cancer that didn’t easily fall into a distinct category using standard diagnostics, can make a huge difference to patient care.

“Many treatments and clinical trials need this category confirmation for patients to be eligible to receive specific treatment. The next step will be to implement this next-generation sequencing technology in routine practice and develop clinical trials for patients based on genetic profiles.”

Les Hereward, 71, a patient on the trial, said: 

“I was diagnosed with lymphoma in 2016 but after a barrage of tests, it still wasn’t clear what type of lymphoma I had, which was very frustrating as it meant my treatment options were very limited. I was delighted to be asked to join this trial at The Royal Marsden last year as I hoped to get some clarity on my condition, which I have since received. Knowing I have follicular lymphoma has made a huge difference to my life in so many ways – I am now on a targeted treatment with a much better outlook and feel better than ever before. I can live my normal life and have been able to join support groups specific to my condition. Taking part in this trial has been a hugely beneficial life experience and the level of care I’ve received at The Royal Marsden has been outstanding.”

This trial forms part of The Royal Marsden Cancer Charity’s commitment to funding research at The Royal Marsden, investing over £30million over five years into research to save and improve the lives of people with cancer.

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