TRANSFORMING MOLECULAR NEUROPATHOLOGY FOR BRAIN TUMOUR PATIENTS IN THE UK: LESSONS FROM THE TESSA JOWELL CENTRE OF EXCELLENCE PROGRAMME

Abstract AIMS Molecular neuropathology using advanced genomics to better delineate brain tumours and help identify ther- apeutic targets is vital to improve patient outcomes. As part of the Tessa Jowell Centre of Excellence (TJCoE) programme, we conducted a national review of neuropathology at 21 UK neuro-oncology centres and present a comparison of data available in 2021 and 2024. METHODS The TJCoE process assesses the treatment, care and research delivered by UK neuro-oncology centres against standards defined by 22 experts. Through an extensive application form, we collected 168 data points across patient treatment, care and research, with additional data input from over 40 hours of interviews and feedback from 1,000 brain tumour patients collected by the Brain Tumour Charity. We compared anonymised molecular neuropathology data collected from 21 centres in 2021 and 2024. RESULTS Overall genetic testing more than doubled between 2021 and 2024, from 2,946 to 6,730 samples tested, with significant increases in methylation array, gene panel and to a lesser extent WGS testing. 6/21 (29%) centres did not conduct whole genome sequencing (WGS) in 2024. The average turnaround time for integrated diagnosis increased 31% from 16 days in 2021 to 21 days in 2024. Turnaround times improved/decreased for 45% (9 out of 20), but increased for 55% (11 out of 20). Centres reported diverse challenges including access to snap freezing, prolonged genomic turnaround times, and issues with testing arrangements outside of England. Variability between centres reported in 2021 remains in 2024, with differences in staffing, testing and access to genomic tumour advisory boards. The number of centres reporting regular audits tripled from 2021 to 2024. CONCLUSION Between 2021 and 2024, the range of molecular neuropathology testing has expanded significantly, yet inequal- ities persist across the UK. The TJBCM is actively collaborating with key stakeholders to tackle these challenges.