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Test Code NONTP Neuro-Oncology Panel, Tumor

Secondary ID

64905

Useful For

Identifying mutations that may support a diagnosis for patients with tumors of the central nervous system

 

Identifying mutations that may help determine prognosis for patients with tumors of the central nervous system

 

Identifying central nervous system tumors that may respond to targeted therapies by assessing multiple gene targets simultaneously

 

Identifying specific mutations within genes known to be associated with response or resistance to specific cancer therapies

Additional Tests

Test ID Reporting Name Available Separately Always Performed
SLIRV Slide Review in MG No, (Bill Only) Yes

Testing Algorithm

When this test is ordered, slide review will always be performed at an additional charge.

Method Name

Polymerase Chain Reaction (PCR)-Based Next-Generation Sequencing

(PCR is utilized pursuant to a license agreement with Roche Molecular Systems, Inc.)

Reporting Name

Neuro-Oncology Panel, Tumor

Specimen Type

Varies


Advisory Information


At least 20% tumor is required for this assay. The amount of tissue needed is dependent on a variety of preanalytical factors (eg, cellularity, ischemic time, fixation). In general, the minimum specimen adequacy for this test is approximately a 1 cm(2) area of tissue (can be over multiple slides) or 5,000 total cells.



Specimen Required


Preferred:

Specimen Type: Tissue

Container/Tube: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded tissue block.

 

Acceptable:

Specimen Type: Tissue

Slides: 1 Stained and 10 unstained

Collection Instructions: Submit 1 slide stained with hematoxylin and eosin and 10 unstained, nonbaked slides with 5 micron-thick sections of the tumor tissue.


Specimen Minimum Volume

Tissue: Entire block. Slides: One or more stained and coverslipped cytology slides with at least 5,000 total nucleated cells and at least 20% tumor cells

Specimen Stability Information

Specimen Type Temperature Time
Varies Ambient (preferred)
  Frozen 
  Refrigerated 

Reject Due To

No specimen should be rejected.

Clinical Information

Molecular analysis of biomarkers is increasingly being used in oncology practice to support and guide diagnosis, prognosis, and therapeutic management. Within the context of central nervous system (CNS) tumors, molecular profiling allows for robust delineation of diagnostic groups characterized by distinct molecular profiles with superior prognostic significance than histologic classification alone. Targeted cancer therapies are defined as antibody or small molecule drugs that block the growth and spread of cancer by interfering with specific cell molecules involved in tumor growth and progression. Multiple targeted therapies have been approved by the US FDA for treatment of specific cancers. Integrated molecular profiling allows for effective identification of mutations associated with response or resistance to specific targeted therapies, which can guide therapeutic management while minimizing treatment costs and therapy-associated risks. The Neuro-Oncology Panel interrogates targeted regions across 50 genes to assess for the presence of somatic mutations. The results of this test can be useful for diagnosis, prognostication, and therapeutic management for patients with CNS tumors.

 

See Targeted Gene Regions Interrogated by Neuro-Oncology Panel in Special Instructions for details regarding the targeted gene regions identified by this test.

Reference Values

An interpretive report will be provided.

Interpretation

An interpretive report will be provided.

Clinical Reference

1. Eckel-Passow JE, Lachance DH, Molinaro AM, et al: Glioma Groups Based on 1p/19q, IDH, and TERT Promoter Mutations in Tumors. N Engl J Med 2015 Jun 25;372(26):2499-2508. doi: 10.1056/NEJMoa1407279

2. Brat DJ, Verhaak RG, Aldape KD, et al: Cancer Genome Atlas Research Network. Comprehensive Integrative Genomic Analysis of Diffuse Lower-Grade Gliomas. N Engl J Med 2015 Jun 25;372(26):2481-2498. DOI: 10.1056/NEJMoa1402121

3. Ceccarelli M, Barthel FP, Malta TM, et al: Molecular Profiling Reveals Biologically Discrete Subsets and Pathways of Progression in Diffuse Glioma. Cell 2016 Jan 28;164(3):550-563. doi: 10.1016/j.cell.2015.12.028

4. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK: WHO classification of tumours of the central nervous system. Fourth edition. International Agency for Research, Lyon, France. 2007

5. Nabors LB, Portnow J, Ammirati M, et al: Central Nervous System Cancers Version 1.2015. J Natl Compr Canc Netw 2015 Oct;13(10);1191-202

Day(s) and Time(s) Performed

Monday through Friday; Varies

Analytic Time

12 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

81445

Targeted genomic sequence analysis panel, solid organ neoplasm, DNA analysis, and RNA analysis when performed, 5-50 genes (eg, ALK, BRAF, CDKN2A, EGFR, ERBB2, KIT, KRAS, NRAS, MET, PDGFRA, PDGFRB, PGR, PIK3CA, PTEN, RET), interrogation for sequence variants and copy number variants or rearrangements, if performed

LOINC Code Information

Test ID Test Order Name Order LOINC Value
NONTP Neuro-Oncology Panel, Tumor 38179-8

 

Result ID Test Result Name Result LOINC Value
43685 Result Summary 50397-9
43686 Result 38179-8
43687 Interpretation 69047-9
43688 Additional Information 48767-8
43689 Specimen 31208-2
43690 Source 31208-2
43691 Tissue ID 81178-6
43692 Released By No LOINC Needed

Forms

If not ordering electronically, complete, print, and send an Oncology Test Request Form (T729) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/oncology-request-form.pdf)