{"entity":{"id":"idea-bio1-multiregion-blocks-default","kind":"idea","name":"Bank three spatially separate tumour blocks from every resection","aka":[],"tldr":"Hospitals usually keep one piece of a removed tumour. Keeping three pieces from different parts would show how varied the tumour is, at almost no extra cost.","summary":"TRACERx showed that a single region misses subclonal drivers and under-calls copy-number heterogeneity in a large share of lung cancers. Pathology protocols could mandate three or more spatially annotated blocks (core, edge, invasive front) frozen and formalin-fixed for every resected solid tumour, with the region map stored with the specimen. The marginal cost is technician time; the payoff is a national multi-region resource attached to outcomes.","asOf":"2026-09-08","links":[{"label":"TRACERx (NCT01888601)","url":"https://clinicaltrials.gov/study/NCT01888601"}],"tags":[],"related":[],"cancers":["nsclc","colorectal","rcc"],"sections":[],"technologies":["wes-wgs","cgp"],"targets":[],"drugs":[],"companies":[],"institutions":["francis-crick","cruk"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-tumor-heterogeneity","b-data-silos"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Routine three-block banking changes the reported driver or clonality status in at least 10 percent of resected tumours and improves recurrence prediction over single-block profiling.","rationale":"Multi-region sequencing consistently reveals branch drivers and chromosomal instability that single biopsies miss; TRACERx and PCAWG show heterogeneity metrics are prognostic. Banking is cheap; sequencing can follow later.","test":"Two-year pilot in five surgical centres: implement the protocol, sequence a random 500-case subset, and measure the discordance rate between single-block and three-block calls and the improvement in relapse prediction.","maturity":"preclinical-evidence","actor":"clinic","cost":"small","horizonYears":3},"route":"/ideas/idea-bio1-multiregion-blocks-default/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"},{"id":"rcc","kind":"cancer","name":"Renal cell carcinoma","route":"/cancers/rcc/"}],"technology":[{"id":"cgp","kind":"technology","name":"Comprehensive genomic profiling","route":"/technologies/cgp/"},{"id":"wes-wgs","kind":"technology","name":"Whole-exome & whole-genome sequencing","route":"/technologies/wes-wgs/"}],"institution":[{"id":"cruk","kind":"institution","name":"Cancer Research UK","route":"/institutions/cruk/"},{"id":"francis-crick","kind":"institution","name":"The Francis Crick Institute","route":"/institutions/francis-crick/"}],"bottleneck":[{"id":"b-data-silos","kind":"bottleneck","name":"Data silos","route":"/bottlenecks/b-data-silos/"},{"id":"b-tumor-heterogeneity","kind":"bottleneck","name":"Tumour heterogeneity and clonal evolution","route":"/bottlenecks/b-tumor-heterogeneity/"}]}}