Rebooting cancer tissue handling in the sequencing era: toward routine use of frozen tumor tissue.

TLDR: The relevant issues behind the incorporation of optimal tissue sampling techniques into routine pathologic practice are discussed and recommendations for the cancer genomic medicine of the future are made.

Abstract: GENOMICS IS POISED TO REVOLUTIONIZE CANCER TREATment. Whole genome sequencing is becoming more rapid, accurate, and affordable, and the ability to use genomic data to match biologically based therapy to an individual is becoming a reality. As the sequencing endeavor transitions from a heroic effort performed by a dedicated team for a particular patient to a routine component of most, if not all, cancer diagnoses, standards for acquiring appropriate tissue samples also must evolve. This is necessary because an individual’s native (germline) genome must be compared with the genome of the tumor. Deciding how best to obtain these samples and how best to process them for whole genome or exome sequencing is a pivotal yet unresolved issue with several layers of complexity. Pathologists currently optimize tumor sampling and processing to leverage standard diagnostic methods. However, as the new clinical applicability of genomics emerges at a fairly rapid rate, the field of pathology will arrive at the tipping point for a fundamental change in how cancer specimens are handled. In this Viewpoint, we discuss the relevant issues behind the incorporation of optimal tissue sampling techniques into routine pathologic practice and make recommendations for the cancer genomic medicine of the future.