Identifying targetable alterations through molecular profiling is a key part of today’s treatment strategy for many tumour types. Laboratory practice can be divided into three phases: pre-analytical, analytical and post-analytical.


This infographic from Dr Alexander Wyatt (GU genomics expert) and Prof. Frédéric Bibeau (pathologist) provides an overview of pre-analytical phase challenges and practical recommendations on how best to navigate them. Download the pdf version for the full reference list.


Pre-analytical phase: Key considerations

  • The pre-analytical phase comprises test selection, sample collection, patient identification, transportation and handling of the sample, processing, and storage
  • 70% of the issues within the tissue sample workflow occur during the pre-analytic phase. These issues affect the diagnostic process and molecular profiling, ultimately impacting patient care, and result in an increased cost burden for laboratories
  • As we know, numerous HCPs and lab staff are involved in the pre-analytical phase, and issues in any of the steps can lead to erroneous results attributed to the pre-analytical phase


Clinical Takeaways

  • Sub-optimal implementation of pre-analytical phases may impact the accuracy of the following analysis, affecting the results and subsequently impacting patient care and cost
  • Standardisation of and monitoring the pre-analytical steps is crucial, as is documenting any deviations that occur in the process
  • Medical, surgical and pathology departments should work in close collaboration to ensure quality and quantity of the samples

Pre-analytical phase challenges in gastric, prostate and lung cancer


The educational objectives of this programme are to:

  1. Understand how to navigate pre-analytical phase challenges, including how to collect, store, process and prepare the samples
  2. Be able to implement or improve the leading role of the pathologist on the MDT

Dr. Wyatt is an associate professor in Urologic Sciences at the University of British Columbia, Canada. He is a senior research scientist at the Vancouver Prostate Centre and a senior scientist at BC Cancer. Dr. Wyatt has a DPhil in genetics from the University of Oxford. His research goals are to identify associations between genomic alterations and patient outcomes in metastatic prostate and bladder cancer, and to translate these findings into clinical biomarkers. Dr. Wyatt has developed novel laboratory and computational techniques to study plasma circulating tumour DNA (ctDNA). Through application of these methods to clinical trial cohorts, his team has demonstrated that ctDNA is highly representative of metastatic lesions, and that somatic alterations detected in ctDNA can help predict prostate cancer therapy resistance or response.

Frédéric Bibeau, MD, PhD, is a Professor of Pathology at the head of the Pathology Department of the Besançon University Hospital, Franche-Comté University. He is involved in translational research, in immuno-oncology of solid tumors and in gastrointestinal tumor pathology, notably colorectal cancer, both at the diagnostic and research levels. He is responsible for several long courses in pathology and molecular pathology, notably of the GI tract. Since ten years his work has been focused on rectal cancer, microsatellite unstable colorectal cancer, liver metastases after induction treatment, peritoneal carcinomatosis and predictive factors linked to targeted therapies and immunotherapy. He also involved in national and international groups specialized in rare tumors of the peritoneum. He was one of two coordinators of the BIG-RENAPE network, corresponding to a biological and clinical database dedicated to peritoneal carcinomatosis of digestive origin.

Professor Bibeau is author or co-author of 213 publications. He belongs to the board of national and international journals. He is a member of the French Society of Pathology, the International Academy of Pathology, the French Federation of Digestive Oncology (FFCD). He has been an active member of the European Society of Medical Oncology (ESMO) and the ESMO-Precision-Medicine working group.

Prof. Frédéric Bibeau has received financial support/sponsorship for research support, consultation, or speaker fees from the following companies:

Amgen, MSD and Sanofi. 


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Overcoming pre-analytical phase challenges in gastric, prostate and lung cancer

Overcoming pre-analytical phase challenges in gastric, prostate and lung cancer

Medical experts make recommendations for best practice

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This educational programme is supported by an Independent Medical Education Grant from AstraZeneca and Amoy Diagnostics.
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PRECISION ONCOLOGY CONNECT is an initiative of COR2ED, supported by Independent Medical Educational Grants from AstraZeneca, Amoy Diagnostics and Bayer.

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