ACM Global Blog Perspectives from ASCO - a Pathologists Point of View on the Future of Clinical Trial Testing

What does the future of laboratory medicine look like for clinical trials? This was the question that I found myself repeatedly asking at the 2018 annual ASCO meeting in Chicago. This was my first visit to ASCO, which is not surprising considering I'm an anatomic pathologist, and this is a meeting catering to oncologists. However, this is a meeting of great importance to all specialties involved in the treatment of cancer patients. Regularly throughout my training and practice, oncologists would return from ASCO with new tests that they learned about. As a result, following ASCO, we would get requests for new tests that clinicians either wanted us to send out for or bring in house; so to see first-hand the meeting that is responsible for so many changes in our daily clinical practice was a great experience. From a clinical trials point of view, the meeting offered some interesting insight into the landscape of laboratory testing in clinical trials, and possibly into the future direction of laboratory medicine in clinical trials. Important observations were that NeoGenomics announced its partnership with PPD , next-generation sequencers are smaller and more affordable than ever, and testing menus continue to grow at great speed. With testing menus and methods growing so fast to meet the demands of clinical trials, it became clear to me that biopharma companies and CROs need a central lab partner to help them navigate all the testing options available. This got me thinking about several areas that are frequently overlooked when working with a central lab partner: 1. Do you have direct access to your pathologists? Do you know your Pathologists? Communication is essential to everything, particularly clinical trials. If you don't/can't communicate with the labs Pathologists, how do you know your expectations will be met? If you don't know them, how do you know they are quality Pathologists capable of delivering the results you need? When evaluating a lab, talk to the pathologists or people reporting your test results so you can learn about how they interact with you about your study's needs. You can quickly tell if someone "knows their stuff." 2. How transparent is the quality control? Review the quality control (QC) processes the lab performs. Are they stretched thin, or are they focused on quality? Lab visits offer great insight into this. Quality in a lab should be transparent and should follow a culture of safety. This means feedback from all individuals involved in the specimen (from accessioning to diagnosis), should be able to freely communicate about ways to improve. 3. What do they truly excel at? Or What is their biggest strength? Do I want quantity or quality? Does the lab have a broad or more specialized, esoteric testing menu? Tests that provided meaningful data a few years ago may not support the desired endpoints. Newer tests may provide insights but can prove complex when managed on a larger scale, and whether the test is validated, approved or available locally must also be considered. Ultimately, you want a central lab that can balance technical possibilities with study demands. And have the scientific expertise to make accurate diagnoses.To keep up with this dynamically changing clinical trial testing landscape, we are focused on remaining agile, open and transparent in every interaction and communication. We continually explore new ideas and techniques in the field of laboratory research - which is why we launched our Smarter Testing for Oncology services at ASCO.With access to scientific experts and subspecialty pathologists as the foundation, we are able to package our clinical trial services in a powerful way to support the specific testing needs of oncology clinical trials.We'd love to hear your ASCO experience this year and what you think about our new