Abstract A046: The UK Brain Board - Developing an integrated platform for Whole Genome Sequencing analysis that enables rapid molecular stratification into clinical trials

Abstract Background Glioblastoma has seen minimal change in standard of care treatment over the past 20 years and yet few patients are enrolled in clinical trials. The rapid identification of reliable biomarkers and accurate trial stratification is an inherent problem for trial recruitment. Whole Genome Sequencing (WGS) for glioma has been added to the NHS genomics test directory but analytical constraints have contributed to delayed turnaround times that are often inadequate for clinical trial stratification. Stratification into clinical trials was identified as a major driver of WGS requesting but a lack of standardized analysis limits clinical interpretation and subsequent trial recruitment. We hypothesized that a unified and centralized forum, focussed solely on the molecular eligibility for brain cancer clinical trials, would encourage WGS requesting and boost trial recruitment. Methods The UK Brain Board is a centralized UK-wide forum that facilitates WGS interpretation in adult brain cancer to define the molecular suitability for clinical trial enrolment. The meeting has a core team that includes clinical scientists and a consultant neuropathologist, neurosurgeon and oncologist. Data are interpreted in the context of open and future clinical trials to facilitate direct trial referral. Results The UK Brain Board (UKBB) has discussed 897 whole genome datasets since 2023. Initially (2023) this equated to a median of 5 patients per week. By 2025 this had increased to a median of 10 patients and a maximum of 26 patients discussed per week. We have also seen increased attendance with an average of 7 different hospital teams presenting per week and 31 different hospital teams having presented overall. Most patients are discussed on the week of referral and >99% have had targets identified for which molecular therapies exist with PTEN biallelic loss, EGFR amplification and NF1 biallelic loss being most common. We have successfully recruited to 5 clinical trials and have launched a novel precision adaptive platform trial (5G) using data from the UKBB. Moreover, we have seen a significant increase in pharmaceutical interest in UK-based glioma trials and anticipate that the successful performance of the UKBB will encourage further pharmaceutical engagement. Conclusions There is considerable appetite amongst oncologists for dedicated forums to interpret and stratify patients into clinical trials based on WGS. We have shown that rapid interpretation and clinical trial stratification is possible and that by providing this infrastructure routinely we can foster clinical collaboration whilst stimulating pharmaceutical interest. Citation Format: Richard Mair, Juanita Lopez, Jamie Trotman, Mareike Thompson, Mayen Briggs, Kieren Allinson, Patrick Tarpey, Rob Goldspring, Shaveta Mehta, Fiona Collinson, Aled Daniels, Antonia Creak, James Powell, Liam Welsh, Mazhar Ajaz, Karen Foweraker, Kazumi Chia, Sean Main, Diogo Silva, Lucy Brazil, Andrew Ho, Chloe May, Angela Swampillai, Thomas Carter, Sara Meade, Karan Patel, Meera Nandhabalan, Juliet Brock, Elizabeth Lim, Faye Robertson. The UK Brain Board - Developing an integrated platform for Whole Genome Sequencing analysis that enables rapid molecular stratification into clinical trials [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Brain Cancer; 2026 Mar 23-25; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2026;86(6_Suppl):Abstract nr A046.