PATH News Network Daily Edition

The Race to Bring Diagnostics to the Developing World

• College of American Pathologists

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An uptick in ticks is raising alarms. And getting a diagnosis in some parts of the world can take seven weeks or longer.

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Is this a diagnosis that can potentially kill someone in a few days? If that is the case, it's a huge danger.

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This is Path News Network Daily Edition from the College of American Pathologists. I'm Nancy Johnson. It's Monday, June 1st. Ticks are biting us up in the U.S. this season, and federal health officials say the surge is the worst seen in nearly a decade. The Centers for Disease Control and Prevention reports that emergency department visits in April for tick bites reached the highest rate for that month since 2017. Out of 100,000 ER visits, 105 were tick-related. Experts warn the rise could mean more cases of tick-borne illnesses, including Lyme disease, Rocky Mountain, spotted fever, and alpha-gal syndrome, which can trigger an allergy to red meat. Ticks are hitting hard some regions, such as the Northeast and Midwest. Pathologists and clinical laboratories are likely to see increased demand for testing as tick season peaks through June. The Ebola outbreak in Africa has highlighted a long-standing problem. For nearly half the world's population, getting a basic medical diagnosis is still out of reach. Now pathologists at the University of Michigan are leading an international effort to close that gap. They brought together experts from eight countries to tackle severe shortages of pathologists, laboratories, and diagnostic infrastructure in low and middle-income nations. Dr. Cameron Merza is professor of pathology at the University of Michigan and co-director of the Global Pathology and Laboratory Medicine Consortium.

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We do not want to be the Western savior who goes in with a pre, you know, pre uh you know uh preconceived notion of what people might need on the ground. Really, this is thinking about capacity building based on local needs. And if we do not engage with local partners, we will not know what the local needs are.

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In some countries, there may be only one pathologist serving millions of people. In places like Kenya, patients can wait seven weeks or longer for a diagnosis. Delays that can become deadly.

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The patient will most likely, unfortunately, probably pass away because the people who are going to treat this patient have no clue what they're dealing with.

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Even basic specimen handling can be a challenge.

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What is that material sent in? Is it sent in water? Is it dry in air? Here we will have it in a fixative so that the tissue is kind of, you know, processed properly. And then, you know, we have seen images of specimens in shopping bags, you know, being shipped across different places, right? Because that is all that is available to them.

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Digital technology could help bridge some of those gaps by allowing pathologists around the world to review cases remotely in real time.

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If, for example, there is the ability to process specimens on site in a low middle income setting, but the ability to scan that material in into a digital scanning software and get expertise access from like thousands of miles away, you could potentially have an answer within a couple of minutes.

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The consortium is also focusing on educational partnerships designed to strengthen local expertise instead of relying on short-term outside aid.

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It's extending to virtual tumor boards where cases from these countries can be discussed in a de-identified way, where we look at their cases with them and kind of share knowledge about what can be, you know, what can be done.

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The ultimate goal is ambitious, sustainable, locally run healthcare organizations capable of training and retaining their own pathologists. That way, life-saving diagnoses can be delivered faster to patients who need them most. One of the biggest stories out of the American Society of Clinical Oncology conference is promising data about the treatment of pancreatic cancer. Data shows that the RAS inhibitor Diraxin Razib doubled overall survival compared to standard chemotherapy in previously treated patients. Researchers are also scheduled to present studies on GLP1 drugs and cancer progression. New blood and genome-based tests are designed to better predict recurrence and guide treatment. Pathologists are watching closely as molecular diagnostics and biomarker-driven oncology continue taking center stage at the nation's largest cancer meeting. And finally, researchers at Vanderbilt Ingram Cancer Center say a simple blood test may help predict whether high-risk breast cancer patients will respond to immunotherapy. The study, published in Science Translational Medicine, used RNA sequencing from liquid biopsy blood samples to track immune system activity during treatment. Investigators studied patients with HER2-negative breast cancer. The research team found molecular signals linked to T cell activation could help predict response to the immunotherapy drug pimbrolizumabe. Researchers say the approach could eventually help pathologists and oncologists tailor treatment strategies more precisely, although they caution that further validation is needed. That does it for the Daily Edition. Be sure to check the show notes for more information on today's stories. Also, share this newscast with your social media network. And if you've got a story we should be covering, write to us at stories at CAP.org. We're back tomorrow at 5 a.m. Eastern for another episode of the Daily Edition. I'm Nancy Johnson. Have a great day.