Solid Tumor Expanded Panel

This 523-gene test is used to help oncologists deliver precision medicine by providing personalized genomic analysis of patient’s tumor. The expanded panel offers the opportunity for a broader scope of genomic information. For example, it may be useful for patients with limited or ill-defined treatment options and for those considering clinical trials. The addition of tumor mutation burden (TMB) and microsatellite instability (MSI) also enable simultaneous assessment of eligibility for immune checkpoint inhibitors.¹ Next-generation sequencing-based tumor profiling is useful for evaluating many genomic biomarkers simultaneously.

Any significant genomic findings are annotated according to Association for Molecular Pathology (AMP) reporting guidelines. A Quest pathologist will review and validate the results and prepare a report for the treating physician.²

Genomic testing allows for some patients to benefit from treatments that target cancer cells containing specific genetic mutations. Guidelines exist for using results from tumor genetic testing for selection of FDA-approved therapies.

Additionally, the solid tumor expanded panel allows for testing of additional genes that may impact alternative treatments available to the patient. Genomic panel testing allows for diverse data generation and streamlined data analysis, which enables enrollment in specific clinical trials and adaptation of treatment strategies.^3,4

Clinical trial information provided in this test is solely for informational purposes for the physician and does not constitute any endorsement or a recommendation for enrollment of patients in any trial by Quest Diagnostics, its affiliates, or its employees.

The Solid Tumor Expanded Panel was developed for assessment of advanced solid tumors when diagnosis, prognosis, or treatment selection could be informed by the presence of genomic variants and MSI/TMB status. Clinical situations where this panel may be helpful include the following:

• Metastatic or locally advanced disease at presentation
• Tumors with no actionable mutations found in guideline-recommended testing
• Recurrent or metastatic disease that has progressed through all standard-of-care options
• Certain rare tumor types
• Tumors of unknown primary origin

The Solid Tumor Expanded Panel uses next-generation sequencing to detect mutations present in DNA and RNA extracted from formalin-fixed, paraffin embedded (FFPE) tissue sections of solid tumors. The test is designed to detect single nucleotide variants (SNVs) and small insertions/deletions, as well as whole-gene copy number alterations and translocations in a select group of genes. Microsatellite instability (MSI) and/or tumor mutation burden (TMB) is also evaluated. 

• Preferred: Room-temperature, formalin-fixed, paraffin-embedded (FFPE) tissue block containing 200 mm² of tumor tissue with ≥20% tumor content
• Minimum: 10 mm² of tumor tissue with ≥10% tumor content

Yes. The Solid Tumor Core Panel (test code 93234) may be considered. This test provides information on 49 genes from a patient’s tumor specimen that may be helpful in guiding cancer treatment. The genes were selected based on actionability of mutations identified in those genes, using currently available evidence from national and international guidelines and literature. Actionability is defined as information a clinician might find useful to aid in diagnosis, prognosis and/or treatment strategy for a patient.^5,6