CMOCO Panel forms
Today's CMOCO Panels available include:
| Lung Panel | Gastrointestinal (GI) Panel |
Initial Presentation/testing Mutations: EGFR, KRAS, BRAF, ERBB2, METex14 Fusions: ALK, ROS1, METex14, RET, NTRK1/2/3 Amplifications: ERBB2, MET by FISH IHC:PD-L1 (SP263) (if not previously done) | Colorectal Carcinoma Microsatellite instability analysis Mutations: KRAS, NRAS, BRAF, PIK3CA If negative for RAS/RAF, reflex to: FISH: ERBB2 If RAS/RAF negative and MSI-H, reflex to: Fusions: NTRK1/2/3 If MSI-H and MLH1/PMS2 loss (by IHC), MLH1 promotoer hypermethylation |
Resistance to targeted therapy Mutations: EGFR, KRAS, BRAF, ERBB2, METex14 PLUS kinase domain relevant driver (ALK, ROS1, RET) as indicated by clinical history Fusions: ALK, ROS1, METex14, NTRK1/2/3, RET Amplifications: ERBB2, MET by FISH | Pancreatic Carcinoma Microsatellite instability analysis Mutation: KRAS (by NGS) If negative for KRAS mutation, reflex to: Fusions: NRG1, NTRK1/2/3 Mutations: BRAF, ERBB2, SMAD4 |
Relatedness of multiple lesions Mutations: Full panel If truncal mutation negative, reflex to: Fusions: ALK, ROS1, METex14, NTRK1/2/3, RET | GIST Mutations: KIT, PDGFRA If negative for the above genes, reflex to: Fusions: NTRK1/2/3 |
Rapid panel Mutations: Rapid EGFR, Rapid KRAS IHC: ALK, PD-L1 (if not previously done) Will reflex to initial lung panel if EGFR/KRAS negative | Cholangiocarcinoma Fusions: FGFR2/3, ROS1 Mutations: IDH1, BRAF, KRAS |
Rapid KRAS reflex to panel Mutations: Rapid KRAS If negative, will reflex to initial lung panel | Gastric Carcinoma Microsatellite instability analysis FISH: ERBB2 |
| Rapid KRAS (non-NGS) | |
| Rapid MSI | |
Relatedness of multiple lesions (multiple primary vs metastasis) Metations: Full panel Lesions to compare:
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| Non-lung/Non-GI | |
Melanoma - Cutaneous Mutation: BRAF, NRAS, KIT, MAP2K1 If negative for the above genes, reflex to: Fusions: BRAF, ALK, ROS1, NTRK1/2/3 - Uveal Mutations: GNAQ, GNA111 If negative for the above genes, reflex to: Fusions: BRAF, ALK, ROS1, NTRK1/2/3 - Rapid BRAF reflex to panel Mutations: Rapid BRAF If negative, will reflex to appropriate panel above | |
Urothelial Mutations: FGFR2/3, PIK3CA, ERBB2 | |
Breast Mutations: PIK3CA, ESR1, ERBB2 | |
Edometrial Mutations: POLE, CTNNB1, TP53, PTEN | |
Thyroid - Differentiated Thyroid Cancer Mutation: BRAF If negative for BRAF, reflex to: Mutations: RAS Fusions: RET, NTRK, PAX8-PPARg - Anaplastic Thyroid Cancer Mutations: BRAF If negative for BRAF, reflex to: Mutations: RAS, TERT Fusions: RET, NTRK, PAX8-PPARg - Medullary Thyroid Cancer Mutations: RET If negative for RET, reflex to: Mutations: RAS |