NORTHFIELD, Ill. (November 5, 2026)— As precision medicine advances, pathology faces a critical challenge: answering increasingly complex diagnostic questions from smaller tissue samples while preserving tissue for other essential testing.
A new article by the CAP Personalized Health Care Committee, “Doing More With Less Tissue: Multiplex Immunofluorescence and the Future of Anatomic Pathology,” explores how a single cancer biopsy may need to establish a diagnosis, identify treatment-related biomarkers, and support genomic testing. Multiplex immunofluorescence (mIF) offers a way to evaluate multiple protein markers on the same tissue section while preserving spatial relationships among cells.
“The future of pathology isn’t simply about doing more tests. It’s about extracting more meaningful information from every tissue sample,” said Jordan Seth Laser, MD, FCAP, an advisor to the committee.
The potential clinical utility of multiplex approaches extends beyond conserving limited tissue. Applications such as lymphoma evaluation, cancers of unknown primary, and small biopsies, including fine-needle aspiration and cytology specimens, highlight the value of obtaining more diagnostic information from limited samples. These approaches may complement conventional immunohistochemistry by allowing multiple markers to be assessed while minimizing tissue consumption.
Looking ahead, mIF also offers opportunities to better characterize tumor cells, immune cells, and the surrounding tumor microenvironment. Understanding these spatial relationships may become increasingly relevant not only to diagnosis but also to therapeutic decision-making, particularly as emerging treatment modalities, including antibody-drug conjugates and bispecific antibodies, reshape cancer care.
While conventional immunohistochemistry remains essential to routine diagnosis, multiplex approaches represent a complementary and evolving capability, with the potential to bring more comprehensive tissue characterization into clinical practice.
As the field advances, the opportunity extends beyond testing more markers. It is about translating richer information from increasingly limited tissue samples into validated, clinically meaningful insights that can help inform patient care.
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About the College of American Pathologists
As the world’s largest organization of board-certified pathologists and leading provider of laboratory accreditation and proficiency testing programs, the College of American Pathologists (CAP) serves patients, pathologists, and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine worldwide.