A Vision for the Future...Through the Microscope Glass

Article provided by National Reference Laboratory (NRL)

Moving towards consolidation, standardisation and automation in the laboratory to tackle today’s challenges and tomorrow’s complex healthcare landscape

It is a new era in healthcare around the world. With an ageing population and the prevalence of non-communicable diseases on the rise, the time has come for laboratories to keep up and shift their focus towards the future. Feeling the pressure of rising costs, restricting budgets and the need for improved efficiencies, laboratories are increasingly turning to consolidation, standardisation, and automation in their operations. For laboratories operating in the Middle East, where there is a constant race to tackle today’s challenges and meet tomorrow’s complex demands, this pressure to improve and advance operations is even more acute.

The emerging need to reduce the cancer burden in the Middle East

According to the World Health Organization, cancer is the second leading cause of death globally and was responsible for 8.8 million deaths in 2015 (http://www.who.int/mediacentre/factsheets/fs297/en/). Although the number of cancer cases and cancer-related deaths per year in the Middle East may currently be lower than the global average, the reported numbers are expected to continue to rise as cancer risk factors such as smoking, diabetes, obesity and others remain prevalent. Figures from GLOBACAN reveal that in the United Arab Emirates (UAE) alone, 2,935 cases of cancer were reported in 2012 of which 1,257 were fatal.

With the establishment of UAE Vision 2021, the National Agenda emphasises the importance of preventive medicine and seeks to reduce cancer and lifestyle-related diseases such as diabetes and cardiovascular diseases to ensure a longer, healthy life for its citizens. In addition, the Agenda aims to lessen the prevalence of smoking and increase the healthcare system’s readiness to deal with epidemics and other public health risks. The aim is that this will firmly cement the UAE’s position among the best countries in the world with regards to the quality of healthcare (https://www.vision2021.ae/en/national-priority-areas/world-class-healthcare).

The value of diagnostics for patients and providers

As the healthcare landscape continues to evolve over the years, the unwavering commitment to innovation remains vital for all stakeholders. Laboratories continue to play a central role in leading the way in innovation, illustrated by the fact that around 70% of the medical decisions are informed by laboratory results, resulting in precise diagnosis. This accuracy is critical in the global fight to reduce the cancer burden in our societies.

And while there are still many open or unanswered questions related to the biology of cancers, we are constantly gaining a deeper understanding of the complexity of this disease, and we are now better positioned to advancing therapies in our pursuit of a cancer-free world.

In this respect, the move from a ‘one-size-fits-all’ approach towards personalised healthcare in cancer treatment is a major breakthrough. Personalised medicine begins at the diagnosis stage, where, for instance, through advanced staining techniques, pathologists can better understand the characteristics of the specific disease, and therefore establish a well informed and precise diagnosis as the basis for the creation of individualised treatment plans for the patients.

According to Dr Basel Altrabulsi, who is the Chief Medical Officer at the UAE’s National Reference Laboratory (NRL), it is critical to understand more about the advancements in anatomic pathology and the regional availability of these techniques that further increase the importance of the role of in-vitro diagnostics in providing an invaluable source of information to healthcare professionals.

“The prevalence of chronic diseases continues to grow and causes a tremendous strain on the healthcare system in our region and across the globe,” says Dr Altrabulsi. “This increases the importance of having reliable and accurate tools to provide the right information from the start in order to avoid wasting the critical resources and to prevent poor patient outcomes derived from making a wrong diagnosis and prescribing the incorrect treatment.”

“For example, in the diagnosis of cancer and some infectious diseases, staining is an indispensable source of reliable information to make informed decisions,” explains Dr Altrabulsi. “Here at NRL, immunohistochemical staining (IHC), in-situ hybridization (ISH), silver in-situ hybridization (SISH), or dual stained slides, are processed simultaneously for maximum efficiency, with flexible protocols and continuous access to slides for improved throughput. With the advent of new technologies, the application of individual slide staining model enables the use of a fresh reagent for each patient’s sample, preventing tissue cross-contamination and therefore enabling a crisp and clear stain, for every test.”

NRL has validated more than 120 stains at its Anatomic Pathology Centre of Excellence in the UAE– one of the most comprehensive menu of stains in the country - including antibodies for Immunohistochemistry, Immunofluorescence and Special Stains. National Reference Laboratory is a Mubadala Company created in partnership with and managed by Laboratory Corporation of America® Holdings (LabCorp®), a world leading life sciences company, providing comprehensive clinical laboratory services. The Anatomic Pathology Center of Excellence of NRL houses one of the largest pools of pathology subspecialists in the region, and provides one of the largest menus of immunohistochemical stains in the UAE. 

Fighting cancer with science

According to the US National Institutes of Health (NIH), precision medicine is an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.

“We now understand that cancer is a heterogeneous disease,” Dr Altrabulsi says. “Therefore, causes, rates of progression and responses to treatment can be very different among individuals.”

“Ideally, we need to understand the molecular profile of individuals and then tailor medical care to fit each patient. Precision medicine can help in screening for cancer risk, identify tumour diagnosis, classification and prognosis, predict response to treatment, detect tumour recurrence and, most importantly, identify new therapeutic targets. With all these options at our disposal, it is a very exciting time for precision and preventive medicine, as the latest advancements in the diagnostics field are transforming the face of healthcare as we know it today,” adds Dr Altrabulsi.