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A recent ºÚ°µ±¬ÁÏÍø webinar delivered by Mary Jones, Senior Biomedical Scientist at the Royal Cornwall Hospital, explored how modern molecular techniques are transforming cancer diagnosis, therapy selection and patient outcomes. 

As an expert in immunohistochemistry with more than 20 years’ experience, Mary outlined the critical role of cytology samples in genomics and demonstrated how targeted therapies are reshaping survival trajectories for cancer patients.

From Traditional Therapies to Precision Medicine

Historically, cancer treatment options were limited to surgery, cauterisation, radiation and later chemotherapy. The shift towards targeted therapies has fundamentally changed the landscape, enabling treatments based on a tumour’s individual genomic profile rather than its anatomical site.

Modern targeted agents, including monoclonal antibodies and tyrosine kinase inhibitors, offer improved tolerability and survival. Therapies such as HER2-directed treatments, EGFR inhibitors, and checkpoint inhibitors have demonstrated substantial benefits with fewer life-limiting side effects. Research is now progressing towards personalised cancer vaccines.

The Growing Importance of Predictive Biomarkers

Biomarkers now underpin decisions across diagnostics, prognosis, monitoring, toxicity prediction and treatment selection. With more than 500 targeted therapies introduced in the past three decades, accurate genomic profiling has become fundamental in determining which patients are most likely to benefit.

Why Pre-Analytical Handling Determines Success

Mary emphasised that pre-analytical stages—collection, preservation and storage—are the most common sources of error in genomic workflows. Up to 70% of testing failures stem from issues before analysis begins. Key factors include:

• Time to fixation 

• Temperature 

• Cellular quantity 

• Fixation method 

• Presence of necrosis

Cytology samples—including LBC specimens, clots, supernatants and direct smears—are increasingly valuable when biopsies are limited or delayed.

Testing Platforms: The Need for Hybrid Approaches

Laboratories commonly combine methods to balance speed and genomic breadth, such as rapid real-time PCR for urgent results and next-generation sequencing for comprehensive profiling.

Case Study: Cytology-Led Treatment Selection in Ovarian Cancer

A case in which cytology enabled rapid diagnosis and successful genomic testing for a 24-year-old patient with high‑grade serous carcinoma was presented. HRD and BRCA2 testing identified the patient as eligible for PARP inhibitor therapy, significantly improving projected survival.

The Take-ºÚ°µ±¬ÁÏÍø Message

If a cytology sample contains tumour cells, treat it as molecularly valuable from the moment it is collected. Optimising pre-analytics and validating cytology-based genomic workflows accelerates patient access to life‑extending treatments.