Predictive molecular pathology in the time of coronavirus disease (COVID-19) in Europe

Abstract

AimsLung cancer predictive biomarker testing is essential to select advanced-stage patients for targeted treatments and should be carried out without delays even during health emergencies, such as the coronavirus (COVID-19) outbreak.MethodsFifteen molecular laboratories from seven different European countries compared 4 weeks of national lockdown to a corresponding period in 2019, in terms of tissue and/or plasma-based molecular test workload, analytical platforms adopted, number of cases undergoing programmed death-ligand1 (PD-L1) expression assessment and DNA-based molecular tests turnaround time.ResultsIn most laboratories (80.0%), tissue-based molecular test workload was reduced. In 40.0% of laboratories (6/15), the decrease was >25%, and in one, reduction was as high as 80.0%. In this instance, a concomitant increase in liquid biopsy was reported (60.0%). Remarkably, in 33.3% of the laboratories, real-time PCR (RT-PCR)-based methodologies increased, whereas highly multiplexing assays approaches decreased. Most laboratories (88.9%) did not report significant variations in PD-L1 volume testing.ConclusionsThe workload of molecular testing for patients with advanced-stage lung cancer during the lockdown showed little variations. Local strategies to overcome health emergency-related issues included the preference for RT-PCR tissue-based testing methodologies and, occasionally, for liquid biopsy.

Clinical and molecular practice of European thoracic pathology laboratories during the COVID-19 pandemic. The past and the near future

“…The COVID-19 pandemic has a strong impact on clinical and molecular pathology in oncology ( Figure 6 ). 9 , 10 , 11 Delays due to COVID-19 had dramatic changes on the number of underdiagnosed cancer cases and additional cancer deaths, as recently reported by two modelling studies in England. 12 , 13 This is highlighted in the present study by a substantial decrease in the activity in Italy, France, Spain, and the UK, and to a lesser degree in some of the other countries.…”

“…Sustaining clinical and molecular pathology during the COVID-19 pandemic, notably to perform the different diagnostic tests requested by the physicians for hospitalized lung cancer patients could be challenging in the pathology laboratories due to a possible reduced number of healthcare workers (HCWs). 9 , 11 , 16 , 17 Thus, staff members may become infected with SARS-CoV-2 (notably after viral transmission among HCWs or from an external positive COVID-19 individual) and the staff members who came in contact with the infected HCW may be placed in quarantine. This could lead to reduced ability to perform critical steps of the molecular pathology analyses of cancer patients.…”

The Immunopathological and Histological Landscape of COVID-19-Mediated Lung Injury

“…COVID-19 is a major health issue, responsible for more than a million deaths worldwide. Moreover, this pandemic has caused all non-urgent medical procedures to be postponed [ 81 ].…”

Predictive factors testing proposal for NSCLC patients during the COVID-19 pandemic

“…Moreover, Malapelle et al compared 4 weeks of national lockdown from seven different European countries to a corresponding period in 2019 in terms of molecular test workload. Most laboratories (80%) showed a variable reduction in the number of tissue samples analysed [5]. It could be assumed that the great restrictions introduced to accessing specialized medical services in Polish hospitals, resulted in the reducing percentage of newly diagnosed lung cancer patients, as it was observed in many European countries.…”