For the roughly 20% of stage II colorectal cancer patients whose tumours will return after surgery, a new digital pathology tool aims to flag them for chemotherapy before it is too late. Oncologists currently struggle to identify which of these patients need adjuvant chemotherapy, since 80% are already cured by surgery alone. The tool, OncoProg®, analyses standard pathology slides using software to stratify patients into risk categories for recurrence. This two-year project will integrate the CE-marked system into routine workflows at two NHS hospitals, first testing whether oncologists and patients trust the technology, then embedding it fully to collect real-world data on clinical utility and cost-effectiveness. If successful, the system could spare low-risk patients unnecessary chemotherapy while ensuring high-risk patients receive it. The real-world evidence gathered will support a submission to NICE for wider NHS adoption, potentially changing how thousands of early-stage colorectal cancer patients are treated each year without requiring new scans or biopsies.
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Treatment decisions after initial surgery in patients with stage II colorectal cancer (CRC) can be complex. 5-year overall survival (OS) rates for patients with stage II CRC are in the region of 80%, the challenge is identifying the remaining 20% of patients who are at risk of recurrence and who would benefit from adjuvant chemotherapy. OncoProg® is a digital pathology based clinical decision support tool which stratifies patients into risk recurrence categories. The aim of this two-year project is to integrate the clinically validated, CE marked, OncoProg® system into routine pathology workflows and clinical treatment pathways in two major NHS sites. The initial phase of the project will focus on an expansion of a clinical utility study to determine the feasibility of integrating OncoProg® into clinical pathways and assess the confidence of oncologists and patients in the use of such technologies to aid treatment decisions. OncoProg® will then be fully integrated into two sites within the NHS, enabling these sites to fully internalise test provision. The deployment sites will also collect prospective data for the duration of the project. These data will be used to demonstrate the clinical utility, cost-effectiveness and real-world benefits from the system and provide real-world evidence needed to drive market access through a NICE guidance submission. The initial integration of OncoProg® over the duration of this project and the demonstration of real-world efficacy and cost-effectiveness will be built upon to enable larger scale deployment of OncoProg® into multiple sites across the NHS.
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