National Institute for Health and Clinical Excellence (NICE)
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NICE to have 'key role' in adoption of genetic tests by NHS

NICE is to assess new genetic tests as part of a drive to adopt more genetic technology in the NHS, says a new report.

The report from the Human Genomics Strategy Group sets out recommendations for using more genetic technology in the diagnosis, treatment and prevention of disease.

It says NICE's Diagnostics Assessment Programme can play a key role in the clinical evaluation of new genetic tests, by ensuring those that are clinically and cost effective are established rapidly and consistently in the NHS.

It adds that NICE should collaborate with the UK Genetic Testing Network and the NHS Commissioning Board (NHSCB) to develop a process for evaluating the clinical effectiveness of all genetic and genomic tests. This should include developing a set of relevant quality standards.

Genomic technology is a discipline based on recent advances in science that have allowed all of human DNA - the human genome - to be mapped and identified.

The technology allows a person's DNA to be quickly compared to the standard ‘reference' genome, or selected parts of it, for signs of genetic variation. This in turn can give insights into the risk of certain diseases.

Though research is continuing in this area, genomic technology has already led to the identification of the genetic differences that cause around two-thirds of sudden cardiac death.

Genomic technologies are being used to support the stratification of cancer treatment, and NICE has already recommended the use of targeted drug therapy with imatinib for patients with gastrointestinal stromal tumours (GISTs).

More than 1,000 genetic tests are also already available through the NHS to identify disease, allowing for earlier diagnosis and treatment of certain conditions.

The report calls for more mainstream adoption of both genomic technologies and genetic testing, as they have the ability to "transform the delivery of healthcare in the UK".

It says genetic technology allows more patients to receive right treatment at the right time, through selecting specific treatments for people based on the particular nature of their disease.

For example, correct treatment for cancer can be determined by examining the genetic material active inside a tumour.

This is already being seen in bowel cancer, where the gene K-RAS does not work normally in a third of patients. As a result, patients are tested for faults in the gene to determine which treatment is most effective.

Though the government is yet to confirm whether it will carry out the recommendations outlined in the report, Health Secretary Andrew Lansley has pledged new funding for molecular tests for cancer.

Mr Lansley said: "We want to make sure that all patients can benefit from these tests - as soon as the tests are recommended by NICE.

"We have therefore been working to establish a new system to ensure speedy introduction of high quality tests. This is the way forward for the future."

Professor Sir John Bell, Chair of the Human Genomics Strategy Group, added: "Adopting the recommendations in our report would lead to further revolutionary developments in our ability to diagnose, treat and prevent disease, and I urge the government to consider these."

Professor Carole Longson, NICE Health Technology Evaluation Centre Director, commented: "We welcome this report which will enhance the role of NICE and its Diagnostics Assessment Programme in the evaluation of important genetic tests."

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