P17.48.B TRANSFORMING MOLECULAR NEUROPATHOLOGY FOR ADULT BRAIN TUMOUR PATIENTS IN THE UK: INSIGHTS FROM THE TESSA JOWELL CENTRE OF EXCELLENCE PROGRAMME (2021-2024)

Abstract BACKGROUND Molecular neuropathology is undergoing rapid transformation across the UK, driven by technological advances, national strategies, and the growing need for precision medicine in brain tumour care. MATERIAL AND METHODS We evaluated anonymised molecular neuropathology data from 21 UK neuro-oncology centres, representing approximately 84% of the UK population, collected as part of the Tessa Jowell Centre of Excellence for Adults programme in 2021 and 2024. Metrics included genomic testing uptake (methylation arrays, gene panels, WGS, FISH, MLPA, SNP), snap freezing practices, turnaround times (TATs), and audit activity. RESULTS From 2021 to 2024, genomic test submissions increased by 128% (n=2946 to 6730), with annual glioma cases rising 18% (n=3159 to 3722). Use of methylation arrays, gene panels, and WGS grew by 342%, 174%, and 291%, respectively, although the number of samples submitted per centre varied substantially. Uptake of WGS increased from 3/21 centres (14%) to 15/21 (71%). 90% (19/21) centres reported freezing tissue (median of 120 samples per centre per year), although challenges such as freezer capacity and tissue transport were reported. The mean TAT for integrated diagnosis including molecular analysis increased from 16 to 21 days between 2021 and 2024, with the number of centres meeting a 14-day TAT dropping from 10/21 (48%) to 6/20 (30%). Conversely, audit implementation rose from 29% to 86%. CONCLUSION Between 2021 and 2024, molecular neuropathology capacity across UK centres grew substantially. Yet, disparities in access, variable TATs, and infrastructure gaps remain. Encouragingly, increased auditing signals a sector-wide commitment to improving diagnostic standards and equity in care.