Collecting Tumor Cells

DNA Based NGS tests

Who can they help?

Patients with common solid tumours – this includes lung, breast and colorectal cancers, as well as melanomas and GISTs.

What do they do?

Analyses DNA regions from either 22 (MGP-1) or 50 (MGP-2) different genes within a tumour to suggest which approved treatments may be right for the patient. May also give additional information of diagnostic or prognostic use as well as identifying potential off-label treatments and/or clinical trial options. The smaller panel is usually adequate for tumours like lung and colorectal, though melanomas and GISTs may benefit from the larger 50 gene panel, however individual choices may ultimately depend upon what treatment options are likely to be available and what if any testing you have had previously.

Why should I choose one?

It can be quicker and much more cost effective than carrying out multiple single gene tests consecutively. It also minimises the amount of tissue required, which can be critical with tiny biopsy samples.

Which genes are covered?

MGP-1 (22 genes): AKT1, ALK, BRAF, CTNNB1, DDR2, EGFR, ERBB2, ERBB4, FBXW7, FGFR1, FGFR2, FGFR3, KRAS, MAP2K1, MET, NOTCH1, NRAS, PIK3CA, PTEN, SMAD4, STK11, TP53

MGP-2 (50 genes): ABL1, AKT1, ALK, APC, ATM, BRAF, CDH1, CDKN2A, CSF1R, CTNNB1, EGFR, ERBB2, ERBB4, EZH3, FBXW7, FGFR1, FGFR2, FGFR3, FLT3, GNA11, GNAQ, GNAS, HNF1A, HRAS, IDH1, IDH2, JAK2, JAK3, KDR, KIT, KRAS, MET, MLH1, MPL, NOTCH1, NPM1, NRAS, PDGFRA, PIK3CA, PTEN, PTPN11, RB1, RET, SMAD4, SMARCB1, SMO, SRC, STK11, TP53, VHL

DNA Strand

DNA & RNA Based NGS test

Who can they help?

Patients with common solid tumours – this includes lung, breast and colorectal cancers, as well as melanomas and GISTs.

What does it do?

Analyses DNA from 35 and RNA from 23 different gene regions within a tumour to suggest which treatments may be right for the patient. May also give additional information of diagnostic or prognostic use as well as identifying potential off-label treatments and/or clinical trial options. Analysis of RNA permits the detect of larger scale genes rearrangements, often referred to a fusions.

Why should I choose it?

This test is designed to assess the majority of genetic changes that are currently considered potentially actionable with available ‘targeted therapies’. It is frequently requested for patients considering clinical trial and off-label options, especially in cases where ‘standard of care’ testing has failed to identify which genes are driving the tumour.

Which genes are covered?

MGP-3 DNA (SNVs & Small Indels): AKT1, ALK, AR, BRAF, CDK4, CTNNB1, DDR2, EGFR, ERBB2, ERBB3, ERBB4, ESR1, FGFR2, FGFR3, GNA11, GNAQ, HRAS, IDH1, IDH2, JAK1, JAK2, JAK3, KIT, KRAS, MAP2K1, MAP2K2, MET, MTOR, NRAS, PDGFRA, PIK3CA, RAF1, RET, ROS1, SMO
MGP-3 RNA (Gene Fusions): ABL1, AKT3, ALK*, AXL, BRAF, EGFR, ERBB2, ERG, ETV1, ETV4, ETV5, FGFR1, FGFR2, FGFR3, MET, NTRK1*, NTRK2, NTRK3*, PDGFRA, PPARG, RAF1, RET*, ROS1*

*Validated for clinical use, all other gene fusions are for research use only (RUO).

Realtime PCR Curves

Rapid-turnaround single gene tests

Who can they help?

Patients with common solid tumours  – this includes lung and colorectal cancers as well as melanoma.

What do they do?

Examines a single gene at a limited number of sites that have been strongly associated with response or resistance to a specific type of approved therapy in certain cancer types. Occasionally, such tests may also be performed to help refine a diagnosis of give prognostic information

Why should I choose one?

As long as the sample is suitable, results will be delivered within a maximum of 2 working days. So it’s useful when time is critical and you just can’t wait for a more comprehensive test.

Which genes are covered?

BRAF: Common variants at codon 600

KRAS: Common variants at codons 12, 13, 59, 61, 117, 146

NRAS: Common variants at codons 12, 13, 59, 61, 117

EGFR: Common variants at codons 719, 768, 790, 858, 861 & Common exon 19 deletions/exon 20 insertions

Full details of exactly what is included in all our gene panels, including downloadable lists of all the variants evaluated, can be found on our NGS Assay Details page.

Other tests available for clinical use now:

1) MSI & MLH-1 promoter methylation analysis

Both these tests, which were designed for use in accordance with the latest NICE and ACGS guidelines relating to Lynch Syndrome pre-screening, are available upon demand. The MSI assay is also suitable for use (in accordance with FDA guidance) in identifying patients with advance solid tumours who may benefit from immune Check Point Inhibitor (CPI) therapy.

2) Endopredict test (Myriad Genetics)

This test, produced by Myriad Genetics, but performed in-house at Sarah Cannon, is designed to assess the 10 year risk of distant breast cancer recurrence, and thus permit an evaluation of the relative risks/benefits of utilising chemotherapy after surgery to remove the primary tumour.

3) B- and T-cell clonality analysis

These tests are designed to allow the assessment of B- and T-cell clonal expansion in suspected lymphoproliferative diseases.

What’s in development?

1) Our MGP-4 gene panel

We recognise that choosing between our current gene panels, which were developed sometime ago, can occasionally be confusing, and especially difficult in cases where the genes that you may be interested in are in different panels. Consequently, we are planing on launching MGP-4 in early 2020. The DNA based component of this will consolidate the best of our three existing panels, and may be ordered either on its own or with the option to include fusion analysis, either upfront or as a reflex option if analysis of the DNA based component is uninformative. Please click here for full details of what is included in the panel.

2) Rapid turn round assay for actionable gene fusions

Directly actionable gene fusions, such as ALK and ROS1 are typically assessed using alternative techniques like immunohistochemistry (IHC) and Fluorescence In Situ Hybridization (FISH). These can be quicker and cheaper than NGS (which for fusions at least, many more suited to clinical trial screening), however we are hoping to launch some rapid Q-PCR based single gene fusion options which may be even faster/cheaper than IHC/FISH.