食管胃癌 (OGC) 是全球最常诊断的恶性肿瘤之一，与疾病相关的高死亡率相关。预测性生物标志物是可以客观测量并用于指示对治疗干预的可能反应的分子，从而促进个体化癌症治疗。然而，英国各地生物标志物测试的采用和实施仍然存在差异。我们进行了一项修改后的德尔菲研究，为英国 OGC 的最佳实践生物标志物测试制定共识建议。我们采用了两轮在线调查问卷，然后召开了虚拟共识会议。讨论的生物标志物包括 HER2、MSI/MMR 和 PD-L1。主题包括整体生物标志物途径、分析前、分析和分析后考虑因素，包括当前实践中的挑战。 二十六名和十八名参与者分别完成了第一轮和第二轮德尔菲问卷，其中病理学家和肿瘤学家各占一半来自英国各地。在多个主题上达成了共识（>80% 一致），包括路径标准化的要求，其中必须包括整个组织旅程的协调、质量保证流程的要求以确保测试的准确性和有效性，以及需要清晰、详细的病理报告信息可支持治疗决策。肿瘤学家就根据组织学对所有生物标志物进行反射测试达成了共识；然而，病理学家们对与病理学家的工作量和可用性相关的能力的担忧是显而易见的。总体而言，参与者认为反射测试可以提高治疗决策的速度并改善患者护理。这些建议反映了最佳实践，应该实施以支持食管胃癌的多学科团队快速决策。结果反映了标准化的必要性，并证明了那些要求和测试食管胃癌生物标志物的人在临床实践中面临的挑战，这表明了与病理学家能力相关的重大担忧。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Oesophago-gastric cancers (OGCs) are amongst the most commonly diagnosed malignancies worldwide and are associated with high disease-related mortality. Predictive biomarkers are molecules that can be objectively measured and used to indicate a likely response to therapeutic intervention, thus facilitating individualised cancer therapy. However, there remains variation in uptake and implementation of biomarker testing across the UK.We conducted a modified Delphi study to formulate consensus recommendations for best-practice biomarker testing of OGC in the UK. We employed two rounds of online questionnaires followed by a virtual consensus meeting. Biomarkers for discussion included HER2, MSI/MMR, and PD-L1. Topics comprised the overall biomarker pathway, pre-analytical, analytical, and post-analytical considerations, including challenges in current practice.Twenty-six and eighteen participants completed the first and second round Delphi questionnaire, respectively, with an even split of pathologists and oncologists from across the UK. There was consensus (>80% agreement) across several topics, including the requirements for standardisation of the pathway, which must include coordination throughout the tissue journey, requirements for a quality-assured process to ensure accuracy and validity of testing, plus the need for clear, detailed information on the pathology report to support treatment decisions. There was consensus amongst oncologists regarding reflex testing of all biomarkers depending on histology; however, concerns over capacity in relation to workload and availability of pathologists were evident among the pathologists. Overall, participants were in the opinion that reflex testing improves the speed of treatment decisions and improves patient care.The recommendations reflect best-practices and should be implemented to support rapid multidisciplinary team decision-making within oesophago-gastric cancer. Results reflect the need for standardisation and demonstrate the challenges faced in clinical practice by those requesting and testing biomarkers for oesophago-gastric cancer, suggesting significant concerns relating to pathologist capacity.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.