A genomic test that can classify brain tumors in as little as two hours is being rolled out across specialist National Health Service (NHS) centers in England. The rapid test could potentially allow diagnostic information to guide treatment – and, in some cases, surgery – far earlier than is currently possible.
The two-year, £2.1 million NHS pilot will evaluate an approach developed by researchers at the University of Nottingham and Nottingham University Hospitals NHS Trust. Conventional genetic testing for brain tumors is often performed in specialist laboratories, meaning complete classification can take several weeks. The Nottingham approach has reduced this process from 26 days to as little as 2 hours.
The method uses Oxford Nanopore sequencing to rapidly analyze selected regions of tumor DNA. The resulting genomic data are interpreted using ROBIN, software developed to provide comprehensive tumor classification. By concentrating analysis on genetic information relevant to clinical decisions, the workflow aims to deliver actionable results without waiting for conventional testing to be completed.
Its compact footprint could also facilitate implementation in hospital laboratories. Tissue removed during surgery is prepared in the pathology laboratory and loaded onto an Oxford Nanopore sequencer approximately the size of a shoebox. DNA molecules pass through microscopic nanopores, generating the genomic information used to characterize the tumor.
The potential turnaround time was demonstrated in a patient undergoing surgery at Queen’s Medical Centre in Nottingham. After sequencing had been running for approximately 20 minutes, the neuropathology team was able to inform the surgical team that the tumor was likely a glioblastoma.
The pilot represents a shift toward generating detailed molecular information much closer to the point of care. Faster classification could support earlier selection of radiotherapy or chemotherapy, improve access to appropriate clinical trials, and potentially provide surgeons with molecular information while an operation is still underway.
Testing will initially be available through specialist NHS centers, with the pilot assessing whether the workflow can be delivered safely and consistently in routine practice. The longer-term ambition is expansion to neuropathology centers across England, potentially extending rapid genomic diagnosis to thousands of patients each year.
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