When Paul Hofman, MD, PhD, wants to analyze a patient’s tumor biopsy, someone in his office has to package up the tissue, mail it to a lab, and wait 10 days or more for the results. Sometimes, that means his metastatic lung cancer patients have to receive chemotherapy rather than potentially more appropriate immunotherapy or targeted therapy, because he doesn’t want to defer treatment for the fast-moving disease, even for less than 2 weeks.

Dr Hofman, a professor of pathology at University Côte d’Azur (Nice) in France, said in an interview with Cancer Therapy Advisor that he doesn’t know exactly how the lab’s proprietary analysis works, which can limit his understanding of the data. And the analysis costs thousands of dollars.

So, Dr Hofman naturally wondered if he could do the same work in his own hospital’s lab. In a study he presented last month, he showed that he could get similarly accurate results in far less time and at a substantially cheaper cost by conducting such analyses in-house, rather than sending tissue out.1 His study focused on measuring tumor mutational burden, but he said the results also hold true for genomic analysis of tumors.

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In-house analysis “is very valuable to making quick clinical decisions and can be a very robust approach,” Dr Hofman said. “This is not always the case when you send samples outside your lab.”

Naturally, the lab companies disagree.

Foundation Medicine, which offers a tumor mutational burden test as well as genomic sequencing, provides more than just data, its Chief Medical Officer Brian Alexander, MD, MPH, said in an interview. The company’s tests help doctors come up with information they can put to use for their patients, he added.

“What to do with that information is really important, and I think that’s where Foundation really shines,” he said. The tests can reveal predictive biomarkers, but also companion diagnostics, targeted therapies that match a patient’s specific genetic profile, and recurrence risk, said Dr Alexander, a glioma expert, who still sees patients at Dana-Farber Cancer Institute in Boston on Fridays. “I think our challenge now is to turn all that information into actionable knowledge for patients and their physician and present that in a way that helps them make better decisions.”