PHG Foundation are a health policy unit with a focus on how genomics and emerging technologies can provide more effective, personalised healthcare. We help governments, policy makers and health professionals tackle barriers to progress and implement strategic change within health systems to support the effective translation of biomedical research into healthcare.

We have a particular interest in circulating tumour DNA technologies and their potential in terms of cancer management. In 2017 we carried out research and held a workshop on the implementation of the first ctDNA testing services in the NHS, which were facilitating treatment decisions in patients with suspected EGFR mutation positive non-small cell lung cancer. Our work to date on this topic can be viewed here: http://www.phgfoundation.org/research/circulating-tumour-DNA.

We found that while some patients were benefiting from these tests, there were still challenges to be overcome. Our key findings were that: i) The NHS should consider offering ctDNA testing of EGFR in NSCLC to all eligible patients; ii) The NHS should use existing ctDNA testing to maximise access to tyrosine kinase inhibitor therapy; iii) there are lessons that can be learned from exisiting ctDNA services that will support the wider use of ctDNA tests in the future. With the advent of the genomic medicine service in the NHS in England, there are further opportunities to explore in terms of how to optimise use of this technology in lung cancer and beyond.

Looking ahead we are interested the further potential of ctDNA testing in all aspects of cancer management, ranging from further molecular diagnostic testing, monitoring and early detection. We aim to understand the main policy challenges that will have an impact on the use of this technology and to identify areas where more work is needed.