Pan-Tumor Assay for Solid Tumors
GTC’s Liquid Trace Solid Tumor is a pan-cancer highly sensitive test evaluating cfRNA and cfDNA providing highly informative data that can be used for diagnoses, evaluating the host immune response, and identifying biomarkers for predicting responses to various therapies.
GTC’s Liquid Trace Solid Tumor can significantly reduce the need for bone marrow biopsies for hematology patients, especially when obtaining tissue from the tumor is difficult.
Furthermore, Liquid Trace Solid Tumor may provide additional information not detected by tissue biopsies including information on the presence of germline mutations or mutations in the subclones not present in the tissue sample (heterogeneity).
Types of solid tumors Liquid Trace can detect:
- Lung
- Breast
- Thyroid
- Colon
- Oropharyngeal tumors
- Pancreatic
- Ovarian
- Prostate
- HPV
- Cancer of unknown primary (CUP)
Liquid biopsy in its current form is dependent on cfDNA analysis; this method likewise presents multiple challenges. These include variations in DNA shedding between tumors as well as low sensitivity (especially in early-stage cancer), difficulty in detecting fusion genes (i.e., chromosomal translocations leading to the expression of chimeric mRNA from two genes), and inability to reflect the numerous biological processes that modify RNA expression levels, such as alternative splicing, stability, and allele-specific methylation. The latter limitation is critically important as recent studies have shown that RNA testing provides another level of biological information regarding the tumor and its microenvironment.
The Benefits of cfRNA
RNA sequencing has proven to be more sensitive for some types of mutations. Cancer cells typically contain one copy of mutated DNA but numerous copies of RNA. This research is consistent with GTC’s findings that cfRNA has increased sensitivity over cfDNA alone. More specifically, cfRNA allowed GTC’s Liquid Trace to detect more mutations and fusions in hematologic and solid tumor samples, which may be undetected by conventional cfDNA.
- Peripheral blood: 10 mL. EDTA tube is required.
Important: RNA stability is 48-72 hours from blood draw. DNA stability is 7 days from blood draw. Samples received beyond 72 hours may include only DNA results.
Specimen Preparation and Shipping Guidelines
Use the Hematology Transport Kit
- Complete Requisition, making sure all sections are completed in their entirety including client information, patient Information, specimen Information and test Selection. Missing information may delay reporting of test results.
- Diagnosis/patient history is extremely important in rendering the correct interpretation of results and should also be filled out as completely as possible. A copy of a Path report should be included.
- Ensure the specimen is labeled with patient name and number. A minimum of two patient identifiers is required for each specimen.
For blood samples:
- Ship using a cold pack. The cold pack should not directly contact the blood tube. Ship as soon as sample collected with overnight delivery.
Important: RNA stability is 48-72 hours from blood draw. DNA stability is 7 days from blood draw. Samples received beyond 72 hours may include only DNA results.
Genes validated and tested for Mutations in cfDNA testing
Genes validated and tested for Mutations in cfDNA testing
Request Kits
Fill out the form below to request kits. Please refer to the Specimen Requirements page for more details. *GTC will need to set you up in our system if this is your first order.
GTC uses AI in every step of our analysis and it makes a difference in helping make a new discovery daily that improve patient care.
Once the data is offloaded from the sequencer, our AI:
- Assists with mutation analysis, identifying non-mutations and artifacts
- Compares various data sets to explore disease biology
- Provides support for clinical decision making and classification of the disease
- It helps with matching patients to therapeutics and presents clinical trial options
- Aggregates data for report generation and simplifies the results so they are easily understood
Case Study: Prostate Cancer
Background
Prostate cancer is one of the most common solid tumors among men. Multiple therapies have been introduced to improve survival and symptom control. Analysis of circulating tumor DNA and RNA in the blood using liquid biopsies, has become an important tool in the management of prostate cancer. In localized disease, it can distinguish between low-and high-grade cancers and can guide the decision to proceed with or defer tissue biopsy. In advanced tumor states, liquid biopsy has a prognostic value and has been used in clinical trials to assess response.
Clinical History
- 75-year-old male
- With history of prostate cancer presenting for monitoring
Figure 1
Molecular Profiling Findings
- Androgen receptor splice variant 7 (AR-V7) is detected (figure 1)
- t(21;21)(q22;q22) ERG-TMPRSS2 mRNA fusion
- Mutations in TP53, CDK12, and GATA2 genes
- Chromosomal structural analysis shows +7, +8, -11, +12, -13, -14, and others
- Increased PSA mRNA
- Increased Keratin 19 mRNA
- No evidence of germline BRCA1/2, BARD1, BRIP1, CDK12, CHEK1/2, FANCL, PALB2 or RAD mutations
Discussion
Although serum Prostate-Specific Antigen (PSA) is being used for monitoring prostate cancer, PSA levels has often failed to precisely reflect disease burden and extent, and multiple therapies impact patient survival and symptoms without corresponding changes in serum PSA levels. As such, comprehensive analysis of cfDNA and cfRNA using liquid biopsies provides another level of biological information regarding the tumor and its microenvironment. This technique is simple, safe, and easily repeatable throughout disease course and can serve as a prognostic and predictive biomarker as well as a ready tissue source for molecular profiling. In this specific case we were able to evaluate the patient’s AR-V7 (on the RNA level) and Homologous Recombination Repair Gene Mutations status. Men with AR-V7 expression have a shorter progression-free survival, and overall survival when treated with Enzalutamide or Abiraterone, suggesting a possible means of predicting response to these therapies through cfDNA and cfRNA profiling.
Download Case Study Brochure (PDF)
References
- Siegel, R. L., Miller, K. D., & Jemal, A. (2019). authors. Cancer statistics, 2019. CA Cancer J Clin, 69, 7-34.
- Albitar, M., Zhang, H., Charifa, A., Ip, A., De Dios, I., Ma, W., … & Goy, A. (2022). Cell-free RNA in liquid biopsy and biomarkers profiling of hematologic and solid tumors.
- Albitar, M., Zhang, H., Charifa, A., Ip, A., De Dios, I., Ma, W., … & Goy, A. (2022). Combining cell-free RNA (cfRNA) with cell-free total nucleic acid (cfTNA) as a new paradigm for liquid biopsy.
Figure 1: Comparison of findings
from cfDNA and cfRNA
Figure 2: cfDNA Only Provides
Partial Results
How to complete the Genomic Testing Cooperative requisition form.
Download our
Test Requisition
Keep in mind that we do not accept blood samples directly from individuals. Talk with your M.D. to fill out the form for you.
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