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Highly sensitive pan-cancer assay for solid tumors that evaluates cell free RNA and DNA (cfRNA and cfDNA),providing data used for diagnoses, evaluating the host immune response and identifying biomarkers for predicting responses to various therapies, in some types of cancers like lung, brain, breast, thyroid, colon, oropharyngeal, pancreatic, ovarian and prostate. It aids in detecting changes not detected with tissue biopsies, including germline mutations and mutations in the subclones not present in the tissue sample (heterogeneity).
The cfRNA, allows detection of mutations and fusions (more than 1600 genes) in hematologic and solid tumor samples that may be undetected with conventional cfDNA testing. Examples are T-cell and B-cell clonality, HLA Class I Genotyping, Epstein-Barr Virus (EBV),Human Papillomavirus (HPV) and Torque Teno Virus (TTV).
Sensitivity is 0.1 to 0.01 for non-hot spot, 0.01 to 0.001 for hotspot and <0.001 for tumor informed or prior Hx.
For DNA, QNS is rare (<0.1%),but it is higher for RNA (Good DNA results but poor RNA results. Of course, if we receive 3 ml of plasma (6 ml blood), the sample is QNS for performing RNA testing.
VAF (Variant Allele Frequency)value: This value is used to monitor the disease in liquid bx. The high the VAF means higher tumor load. Patients showing reduction in VAF after treatment means they are doing better.
Peripheral blood (10 mL) in a Lavender-top (EDTA) tube.
Important: RNA stability is48-72 hours from blood draw. DNA stability is 7 days from blood draw. Samples received beyond 72 hours may include only DNA results.
CSF (7-10 mL) is optimal (5 mL minimum).
Important: Ship as soon as possible (overnight). Do not use collection devices with anti-coagulants. Clear tubes.
Use cold pack for transport. Make sure cold pack is not in direct contact with specimen.