Neuro-Oncology
175 Brain tumour specialist nurse led, WGS consent clinic
By Naomi Cole.
Abstract
Abstract Introduction The NHS offers whole genome sequencing (WGS) for adults diagnosed with high-grade brain tumours, including gliomas and tumours at the end of the standard of care treatment. Comprehensive genomic profiling enables identification of actionable variants for targeted therapies and clinical trial eligibility, and detection of rare inherited variants with potential familial implications. To streamline delivery of this service, we introduced a Brain Tumour Clinical Nurse Specialist (CNS)-led consent pathway, whereby WGS-trained CNS staff complete the WGS Record of Discussion in the consultant-led neurosurgical oncology clinic. This initiative aims to streamline workload, optimise clinic efficiency, maintain continuity of care, and improve patient access to precision therapies. Method A retrospective audit was conducted to determine the total number of patients consented by the CNS team between 2023 and 2026. The study also evaluated the consenting process to identify operational challenges and areas for service improvement. Results A total of 492 patients were consented during the study period (2023: 137; 2024: 148; 2025: 186; 2026 to date: 21). All patients had a correctly completed WGS Record of Discussion. All patients/families with inherited germline variants have been highlighted to the treating consultant, contacted and referred to a clinical geneticist. The CNS-led pathway significantly reduced consultant clinic burden while maintaining compliance, governance standards, and patient access to genomic testing. Conclusion A specialist CNS-led WGS consenting clinic is an efficient and sustainable model for delivering genomic medicine within neuro-oncology services. This approach maintains high standards of patient care while alleviating pressure on consultant-led clinics and supporting the continued integration of precision oncology within routine practice. Our aim is to develop a Brain Tumour CNS genomic network for training and sharing best practice.