The traditional histological and immune phenotypes have been the backbone of tissue in-situ scientific and diagnostic interrogation for more than a century. However, two major recent developments in modern oncology have challenged this model:

1) the development of molecular oncology applied to tissue nucleic acid (NA) extractions; and

2) the application of digital pathology and artificial intelligence in the interpretation of routine H&E images, single-biomarker images and complex, multiplexing analyses.

Specifically, the Integrated Pathology Team (IPT), within the Molecular Pathology Division at ICR, aims to create new clinical research and diagnostic paradigms for morpho-molecular integration. To do so, the IPT will use established NA-type analyses (predominantly NGS-based) and novel Tissue Hybridization and Digital Pathology approaches using clinical exemplars that offer distinct clinical endpoints.

In particular, IPT will adopt and develop new ULTIVUE and OPAL multiplex assays, including biomarkers associated to immuno-oncology, DNA damage and repair and the cell cycle. In parallel, a pipeline for the application of digital pathology and artificial intelligence interrogation will be used, which will include a mixture of open-source, established products such as QuPath (developed in Professor Salto-Tellez’s laboratory at Queens University Belfast by Dr Pete Bankhead) together with other specific open applications in the artificial intelligence space.

The development of this capacity should allow, within ICR:

1) validation of clinical utility of new biomarkers;

2) delivery of complex tissue-based testing towards ‘accredited’ applications such as clinical trial interrogation or routine diagnostics; and

3) engagement with industry in the delivery of such assays.

The IPT aims to identify those exemplars based on collaborative work with existing Teams within ICR and the Royal Marsden hospital.