Predictive molecular pathology in the time of COVID-19

Abstract

AimsIn the time of COVID-19, predictive molecular pathology laboratories must still timely select oncological patients for targeted treatments. However, the need to respect social distancing measures may delay results generated by laboratory-developed tests based on sequential steps a long hands-on time. Laboratory workflows should now be simplified.MethodsThe organisation of the University of Naples Federico II predictive pathology laboratory was assessed before (March–April 2019) and during (March–April 2020) the Italian lockdown.ResultsThe number of patients undergoing single or multiple biomarker testing was similar in 2019 (n=43) and in 2020 (n=45). Considering adequate samples for molecular testing, before the outbreak, next-generation sequencing was mostly used (35/42, 83.3%). Testing six genes had a reagent cost of €98/patient. Conversely, in 2020, almost all cases (38/41, 92.7%) were analysed by automated testing. This latter had for any single assay/gene a significant reagent cost (€95–€136) and a faster mean turnaround time (5.3 vs 7.9 working days).ConclusionIn the times of coronavirus, laboratory fully automated platforms simplify predictive molecular testing. Laboratory staff may be more safely and cost-effectively managed.

The Impact of the COVID-19 Pandemic and the Associated Belgian Governmental Measures on Cancer Screening, Surgical Pathology and Cytopathology

“…This reflects the continued care for cancer patients. Although Malapelle et al [ 18 ]described a substantial shift from next-generation sequencing towards fully automated molecular pathology, a similar shift was not observed in our laboratory. We do not perform germline mutation testing, but Minucci et al [ 19 ] previously described a COVID-19-related decline in genomic diagnostics.…”

Predictive molecular pathology in the time of coronavirus disease (COVID-19) in Europe

“… 5 21–25 Conversely, on the overall, the degree of predictive biomarker testing decrease was only slight. 13 However, to ensure laboratory staff security, molecular laboratory activities were, in some instances, reshaped and reorganised. 12 13 In this setting, fully automated technologies, needing slight hands-on work, may be useful to limit the amount of time spent to process lung cancer samples.…”

“… 12 13 In this setting, fully automated technologies, needing slight hands-on work, may be useful to limit the amount of time spent to process lung cancer samples. 13 Thus, it is hoped to endorse a technological improvement in terms of automation in molecular pathology laboratories. 13 However, it should be borne in mind that automation is not a surrogate for skilled laboratory staff members.…”

“… 13 Thus, it is hoped to endorse a technological improvement in terms of automation in molecular pathology laboratories. 13 However, it should be borne in mind that automation is not a surrogate for skilled laboratory staff members. A critical attitude is required to interpret and validate the results provided by automated workflows.…”

“… 12 A study from the University of Naples Federico II reported that the number of patients with lung cancer undergoing biomarker testing before (March–April 2019) and during (March–April 2020) the Italian lockdown was similar. 13 However, single laboratory experience is not sufficient to reliably generate robust conclusions at the European level. Thus, a well-established collaborating group of European pathologists from Belgium, France, Germany, Italy, Portugal, Spain and Sweden joined the forces to generate a large database in order to assess whether and what impact COVID-19 has had on lung cancer predictive molecular testing carried out in Europe during the spring 2020 lockdown.…”