NHS plan promises genomic tests for all children with cancer

The Long Term Plan announced by the NHS this week has detailed a proposal to offer whole-genome sequencing for all children with cancer in England.

This move has been welcomed by the cancer research field. Despite ever-improving survival rates for childhood cancer, it remains the single largest cause of death in children aged one to 15 years old.

'It feels appropriate to "throw the kitchen sink", at children's cancers,' said Dr Ewan Birney, director of the European Molecular Biology Laboratory's Bioinformatics Institute.

Recent publications have shown that childhood cancers often result from different mutations in different genes to adult cancer, highlighting the need for paediatric-focused research and therapies. The NHS plans to target this lack of information on childhood cancers through whole-genome sequencing. 

This is likely to involve taking a small sample of the cancer, as well as a sample of healthy cells from each child, and then sequencing the DNA from both to find the specific cancer-causing mutations. 

The hope is that this information would be obtained sufficiently quickly to inform patient diagnosis and treatment, to reduce the use of harmful medications and interventions where they are not helpful.

'Together with researchers and paediatric oncologists who are desperate for more molecularly guided information to improve treatment of their patients, we are committed to developing the evidence for safe and effective implementation in the clinic. What the NHS has announced is an excellent step in this direction,' said Professor Lou Chesler, team leader in paediatric solid tumour biology at the Institute of Cancer Research, welcoming the government's plans. 

Early reports from the 100,000 Genomes Project suggest that sequencing could lead to a potential for a 50 percent increase in 'clinically actionable' data that can inform treatment, potentially sparing cancer sufferers from the lifelong health problems that can be caused by high doses of chemotherapy and radiotherapy.

While the response to the government's plans have been largely positive, some have questioned whether the infrastructure, training and expertise are available to provide these improved services. William Newman, professor of translational genomic medicine at Manchester University and vice-chair of the British Society for Genetic Medicine, said that this was to be expected.

'When you set out an ambition it doesn't mean everything will be in place from day one, but it gives a clear steer on the direction of travel,' Professor Newman said. 'It's good to be set a challenge that will put you at the forefront of medicine.'