All Solid Tumours

Oncode offers range of next-generation sequencing (NGS) panels for all solid tumours including pancreatic, prostate, liver, kidney, melanoma etc. Besides covering the more common solid tumours, Oncode also offers molecular profiling panel for sarcoma, which is relatively rare but molecular determination of translocations and fusions are important to make conclusive determination. Oncode tests range from smaller panel like ONCODEcipher LiquidPinpoint panel to comprehensive panels. Oncode also offers MSI testing using PCR and fragment analysis technique.

ONCODEcipher LiquidPinpoint
ONCODEcipher LiquidPinpoint is a NGS panel targeting 5 most important genes that are frequently mutated in solid tumours cancer, given as EGFR, ALK, BRAF, NRAS and KRAS using only the blood of the patients.

Specimen Requirements:
15ml blood in Streck tubes

Turn Around Time:
10 working days

Shipment Requirement:
Keep specimen at room temperature. DO NOT ship on ice or dry ice or expose to direct sunlight.

ONCODEcipher Liquid28
ONCODEcipher Liquid28 is a NGS panel that delivers information on a variety of treatment-informative mutations in the 28 genes which are known to play a role in cases of solid tumours using only the blood of the patients.

Specimen Requirements:
15ml blood in Streck tubes

Turn Around Time:
10 working days

Shipment Requirement:
Keep specimen at room temperature. DO NOT ship on ice or dry ice or expose to direct sunlight.

ONCODEcipher Comprehensive
ONCODEcipher Comprehensive is a targeted NGS panel that simultaneously detects and characterizes single nucleotide polymorphisms (SNVs) and insertions and deletions (indels) in 67 genes associated with solid tumours.

Specimen Requirements:
• FFPE block OR 10 FFPE Slides (10µm thick sections) with at least 30% tumour cellularity
• 1 H&E stained slide cut from same block

Turn Around Time:
10 working days

Shipment Requirement:
Keep specimen at room temperature. DO NOT ship on ice or dry ice or expose to direct sunlight.
ONCODEcipher Extended
ONCODEcipher Extended is a targeted NGS panel targeting 36 genes commonly mutated in solid tumours for fusion (ALK, ROS, MET, RET etc.) and mutation (EGFR, KRAS, NRAS, BRAF, ALK etc.).

Specimen Requirements:
• FFPE block OR 10 FFPE Slides (10µm thick sections) with at least 30% tumour cellularity
• 1 H&E stained slide cut from same block

Turn Around Time:
10 working days

Shipment Requirement:
Keep specimen at room temperature. DO NOT ship on ice or dry ice or expose to direct sunlight.
ONCODEcipher MSI
Microsatellites are short, tandemly repeated DNA sequences from 1-6 base pairs in length. Microsatellite markers can be used to detect a form of genetic instability called Microsatellite Instability (MSI). MSI is a consequence of germline or somatic inactivation of mismatch repair (MMR) deficient. Loss or down-regulation of the expression of the protein products of these genes results in failure of the DNA mismatch repair system.

NCCN guideline recommends testing all patients with colorectal cancer for Lynch syndrome also known as Hereditary non-polyposis colorectal cancer (HNPCC) for better treatment planning. MSI occurs in more than 90% of patients with Lynch syndrome. MSI can also occur in the absence of Lynch syndrome as they are found in about 15% of colon cancers without Lynch syndrome. Family members who are at risk of inherited the familial mutation of Lynch syndrome can be tested to determine whether they are at risk for developing colorectal cancer and if so, they should undergo frequent surveillance screening[1].

Earlier studies have suggested that metastatic colorectal cancer patients with high levels of MSI indicates a better prognosis and is more sensitive to immunotherapy (pembrolizumab). Recent studies have shown that MSI is also a useful indicator for predicting response to immunotherapy in any solid tumour type[2].

ONCODEcipher MSI test is a PCR and fragment analysis assay to detect the increase in length of the microsatellite segment by comparing microsatellite allele size variations between normal and tumour samples in five mononucleotide repeat markers (BAT-25, BAT-26, NR-21, NR-24 and MONO-27) and two pentanucleotide repeat marker (Penta C and Penta D).

Specimen Requirements:
Tumour FFPE block OR 10 FFPE Slides (10µm thick sections) with at least 30% tumour cellularity & 1 H&E stained slide cut from same block AND
Non-Tumour 3ml blood in EDTA tube OR FFPE Block OR 10 unstained Slides (10µm thick sections) of non-tumour tissue

Turn Around Time:
10 working days

Shipment Requirement:
Keep specimen at room temperature. DO NOT ship on ice or dry ice or expose to direct sunlight.
References:
1. Bacher, J.W. et al. (2015). Improved detection of microsatellite instability in early colorectal lesions. PLoS ONE 10(8): e0132727. READ MORE
2. Le D.T., Durham J.N., Smith KN, et al. (2017) Mismatch-repair deficiency predicts response of solid tumors to PD-1 blockade. Science, DOI: 10.1126/science.aan6733.