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A world-first NHS pilot of a rapid genomic test that allows doctors to diagnose what type of brain tumour a patient has in up to 24 hours is being expanded across England, with support from a collaboration of teams across Birmingham.

Brain tumours are notoriously difficult to diagnose and treat, and there are more than 100 different types ranging from slow-growing tumours to aggressive cancers.

The standard process for diagnosing brain tumours involves doing MRI and CT scans and then extracting a tumour sample. This is taken away, tested, and examined in a pathology lab, taking weeks to diagnose the type of tumour.

The new test means that patients can receive a definitive brain tumour diagnosis in less than a day, rather than the current average of 26 days.

A two-year pilot, made possible as part of a newly created Network of Excellence co-led by the NHS Central and South Genomic Medicine Service and NHS East Genomic Medicine Service, will explore the success and feasibility of offering the test within a clinical setting. The aim is for the test to be rolled out to all neuropathology centres in England to benefit all patients as soon as possible.

Dr Victoria Wykes, Honorary Consultant Neurosurgeon at Queen Elizabeth Hospital Birmingham, Associate Clinical Professor of Neurosurgery at University of Birmingham, and Clinical Lead of the Network of Excellence for Rapid Diagnosis in Brain Tumours, described rapid genetic testing technology as a major advance in patient care.

She said: "Achieving a rapid diagnosis of brain tumours represents an absolute game-changer for our patients. It will reduce the time that patients and their loved ones have to wait to understand what the life-changing diagnosis means and accelerate the speed of accessing treatment, therapies and clinical trials. The test can also allow surgeons to receive the diagnosis during operations to remove tumours, enabling them to tailor the surgery according to the tumour type while the patient is still in theatre.

“Partners across Birmingham’s Health and Life Sciences Quarter will come together to play a vital role in leading the clinical operational delivery of this new genetic test within the NHS, evaluating its use in clinical settings where it will hopefully have incredible results for patients in Birmingham and the Midlands.”

Queen Elizabeth Hospital Birmingham, part of University Hospitals Birmingham, and University of Birmingham have the existing infrastructure needed to rapidly analyse tumour samples during surgeries. This is thanks to an established tissue pipeline and significant genomics expertise in brain cancer, already used for research.

The Birmingham-based team from the hospital and university will lead on examining and evaluating how to make clinical practice of the new test a reality, focusing on health economics, implementation science and genomic training within the programme.

This work is a fantastic example of the collaborative research ecosystem between the NHS and academia. It builds upon the Tessa Jowell Brain Matrix platform study, funded by The Brain Tumour Charity and led by Professor Colin Watts; genomics expertise provided by Professor Andrew Beggs and his team; and the brain tumour tissue pipeline BRAIN STAT, led by Dr Victoria Wykes with philanthropic funding from Robert Spier through The Development and Alumni Relations Office at University of Birmingham.

Shalina, a 45-year-old, mother of two from Birmingham, explains why waiting times matter so much to patients: “When I was undergoing tests for a suspected brain tumour, the wait was agonising. I waited six weeks to get a precise diagnosis for my tumour. With a young family, life had to go on, but living with the uncertainty was incredibly difficult. It was hard at times to carry on as normal as my husband and I decided not to tell anyone until the results had arrived, as we knew they would have so many questions that we would have been potentially unable to answer.

“I was fortunate that my results came back showing that the tumour was low-grade, I have since undergone treatment, and I’m doing well. For those people whose tumours are more advanced or harder to treat, any reduction in time to diagnose means that steps can be taken sooner to give them the very best chance of recovery. You cannot underestimate how important this is to families affected.”

As part of the pilot expansion, the new Network of Excellence for Rapid Diagnosis in Brain Tumours has been awarded £2.1million from NHS England. This funding will ensure that over the next two years, genomic diagnosis will be available to people with brain cancers across the country. The funding bid was co-led by the NHS Central and South Genomic Medicine Service, a key player in Birmingham’s health and life sciences ecosystem.

Clinical leadership for the Network of Excellence comes from the University of Birmingham and University Hospitals Birmingham, with scientific leadership from the University of Nottingham, whose researchers invented the test, and Nottingham University Hospitals Trust. Teams across these establishments, as well as the South-East and North Thames Genomic Medicine Services, have all had a significant role in shaping the Network of Excellence.

Further expanding on the importance of feasibility testing, Dr Wykes explained: “Through the strength of our network, we will seek to validate the effectiveness of the tools for rapid genomic diagnosis of brain tumours, and determine how we make rapid diagnosis work in the real world. By the end of the programme, we will be able to make recommendations for the tools to be commissioned by the NHS, helping to unleash the full potential of this new test.”

The NHS England pilot builds on the successful pilot already underway in Birmingham and Nottingham and will initially take the technology into five specialist centres before expanding further across England.

The first phase will introduce the testing across University Hospitals Birmingham NHS Foundation Trust, Nottingham University Hospitals NHS Trust, Great Ormond Street Hospital for Children NHS Foundation Trust, King's College Hospital NHS Foundation Trust and Newcastle Hospitals NHS Foundation Trust.

Additional genomic laboratory sites in Bristol, Oxford, Leeds and Manchester will join in the second phase.