ROBIN: a unified nanopore-based assay integrating intraoperative methylome classification and next-day comprehensive profiling for ultra-rapid tumour diagnosis

Brain tumours are routinely classified based on their epigenetic signatures. Current testing relies on microarrays which have high capital costs and require multiplex batch processing. The average turnaround time takes days to weeks. ROBIN (Rapid nanpOre Brain intraoperatIve classificatioN) is an Oxford Nanopore-based tool for providing real-time, intraoperative methylome classification and next-day comprehensive molecular profiling within a single assay. The tool uniquely integrates three methylation classifiers to improve performance.

Key points:

• ROBIN achieved a turnaround time of two hours, meaning surgeons could receive the results mid-operation and tailor their approach accordingly

• 38 cases (76%) within the prospective cohort were classified intraoperatively

• The initial classifier identified 90% of tumours correctly according to the fully integrated diagnosis available the next day