Connect tumor molecular findings to evidence for targeted therapies, immunotherapy, and drug resistance while accounting for cancer type and disease stage.
The objective is not simply to enumerate variants. Reports must indicate whether a biomarker has evidence for a specific tumor type and treatment line. DNA, RNA, IHC, and ISH tests can be complementary. Final therapeutic decisions rest with the treating team and the full clinical picture.
The listed assays are examples, not confirmed available services. Clinical indications, assay validation, and specimen requirements must be checked with the laboratory.
Examples for discussion with an oncologist; test selection must reflect the clinical circumstances of each patient.
Driver alteration status and PD-L1 expression are required to guide initial treatment.
Validated comprehensive DNA/RNA profiling and PD-L1 IHC; plasma ctDNA may help if tissue is limited.
Assess EGFR, ALK, ROS1, MET exon 14, RET, NTRK, BRAF and relevant additional targets. Negative plasma ctDNA does not rule out the need for tissue testing.
The team must determine eligibility for or resistance to selected targeted regimens.
Tumor RAS/RAF assessment, MSI/MMR status, and appropriate additional biomarkers based on the intended regimen.
Specific KRAS, NRAS and BRAF variants and tumor sidedness may change interpretation; assay results require disease-specific context.
Eligibility for DNA-repair-directed treatment may be relevant in a defined clinical setting.
Appropriate BRCA1/2 germline/tumor testing and, where indicated, a validated HRD assay.
A pathogenic BRCA result and a genomic scar score are different findings; interpretation depends on indication and treatment history.
The treating team is considering checkpoint blockade and needs biomarker context.
Use the indicated PD-L1 assay, MSI/MMR testing, and selected TMB testing when supported by the cancer type and regulatory indication.
No single marker predicts immunotherapy benefit across every cancer or regimen; use disease-specific criteria.
Each entry specifies the sample, testing goal, and clinical context to avoid confusion.
Broad profiling for drivers and resistance changes in eligible tumors
Detect therapeutically relevant fusions including ALK, ROS1, RET and NTRK
Molecular testing when tumor tissue is limited or at progression
Assess PD-L1 expression for relevant immune checkpoint indications
Determine mismatch-repair status for selected treatments
Assess HER2 and ER/PR for applicable tumor types
Evaluate homologous recombination repair biomarkers in applicable settings
Quantify mut/Mb using a validated method when clinically indicated
Define the relevant clinical information and expected report components before discussing testing with the scientific team.
Cancer subtype, stage, previous therapies, and current clinical intent
Prior biomarker results, pathology, and sample suitability
Relevant drug access and guideline context for the treatment setting
Actionable alterations and evidence contextualized by cancer type and indication
Method and analytic limitations, especially negative liquid biopsy findings
Recommendations for additional testing or multidisciplinary molecular review as appropriate
• The same variant may have different evidence levels across cancer types and lines of therapy.
• A negative liquid biopsy result may require reflex tissue testing because of low tumor DNA shedding.
• Companion diagnostic requirements, validated cutoffs, and current local approvals must be checked before treatment selection.
Describe the clinical question and available data in the support form; do not send patient identifiers.
