Collect

Fresh Tissue 150 mg or 0.5-2.0 cm3 fresh tissue in transport media. Deliver within 24 hours at room temperature.

Fresh Frozen Tissue 150 mg or 0.5-2.0 cm3 tissue snap frozen at -20°C. Store at -20°C. Ship on minimum of 10 lbs. of dry ice in an insulated container by overnight courier.

FFPE preferred sample: minimum six 20-um scrolls or 10 slides that are freshly cut before shipping to us via overnight delivery. It would be best to cut and ship Wednesday to arrive on Thursday. Alternatively, a whole FFPE block can be sent.

Unacceptable Conditions

Unacceptable conditions include no tumor in tissue or specimens fixed/processed in alternative fixatives.

Storage/Transport Temperature

See above.

Volume Required

See above

Minimum Required

see above

Phlebotomy Draw

No

Performing Lab

Division of Genomic Diagnostics

Performed

Monday-Friday 9:00am - 4:00pm

Reported

21 days

Detection Rate

The Comprehensive Solid Tumor Panel includes the V2.1 Solid Tumor Panel for sequence and copy number analyses of 238 cancer genes and two genes associated with cancer pharmacogenomics, and V3 Fusion Panel which targets over 700 exons of 117 cancer genes. 

Utility

Facilitates disease diagnosis, risk stratification, and therapeutic decision-making.

Synonyms

  • Solid Tumor, Fusion panel, Comprehensive
  • COMST
  • ABL1, ACVR1, AKT1, AKT2, AKT3, ALK, APC, AR, ARAF, ARID1A, ARID1B, ARID2, ASXL1, ATM, ATR, ATRX, AURKA, AURKB, AXIN1, AXL, B2M, BAP1, BARD1, BCL2, BCL6, BCOR, BCORL1, BLM, BRAF, BRCA1, BRCA2, BRD4, BRIP1, CARD11, CBFB, CBL, CCND1, CCND2, CCND3, CCNE1, CD274, CD79B, CDC73, CDH1, CDK12, CDK4, CDK6, CDK8, CDKN1B, CDKN2A, CDKN2B, CDKN2C, CHEK1, CHEK2, CIC, CREBBP, CRKL, CRLF2, CSF1R, CTCF, CTNNB1, DAXX, DDR2, DICER1, DNMT3A, DOT1L, EED, EGFR, EP300, EPHA3, EPHA5, EPHB1, ERBB2, ERBB3, ERBB4, ERG
  • ESR1, ETV6, EZH2, FANCA, FANCC, FBXW7, FGF19, FGF3, FGF4, FGFR1, FGFR2, FGFR3, FGFR4, FLCN, FLT1, FLT3, FLT4, FOXL2, FOXP1, FUBP1, GATA1, GATA2, GATA3, GNA11, GNAQ, GNAS, GRIN2A, GSK3B, HGF, HNF1A, HRAS, H1-2, H3C2, H3-3A, IDH1, IDH2, IGF1R, IKBKE, IKZF1, IL7R, INPP4B, IRF4, IRS2, JAK1, JAK2, JAK3, JMJD1C, JUN, KDM5A, KDM5C, KDM6A, KDR, KEAP1, KIT, KMT2A, KMT2C, KRAS, MAP2K1, MAP2K2, MAP2K4, MAP3K1, MAPK1, MCL1, MDM2, MDM4, MED12, MEF2B, MEN1, MET, MITF, MLH1, MPL, MRE11 (MRE11A), MSH2, MSH6
  • MTOR, MUTYH, MYB, MYC, MYCN, MYD88, MYOD1, NF1, NF2, NFE2L2, NKX2-1, NOTCH1, NOTCH2, NPM1, NRAS, NSD2 (WHSC1), NTRK1, NTRK2, NTRK3, PALB2, PAX5, PBRM1, PDCD1, PDGFRA, PDGFRB, PHOX2B, PIK3CA, PIK3CG, PIK3R1, PIK3R2, PIM1, PPM1D, PPP2R1A, PRDM1, PRKAR1A, PTCH1, PTEN, PTPN11, RAD50, RAD51, RAF1, RARA, RB1, RET, RHOA, RICTOR, RNF43, ROS1, RPTOR, RUNX1, SDHA, SDHB, SDHC, SDHD, SETD2, SF3B1, SMAD2, SMAD4, SMARCA4, SMARCB1, SMO, SOCS1, SOX2, SPEN, SPOP, SRC, STAG2, STK11, SUFU, SUZ12, TENT5C (FAM46C)
  • TERT, TET2, TGFBR2, TNFAIP3, TNFRSF14, TOP1, TP53, TP63, TSC1, TSC2, TSHR, U2AF1, VHL, WT1, AMER1, XPO1, NUDT15, TPMT, ABL2, ARHGAP26, BCR, BRD3, CAMTA1, CBFA2T3, CCNB3, DNAJB1, DUSP22, EPOR, ESRRA, ETV1, ETV4, ETV5, EWSR1, FGR, FOXO1, FUS, GLI1, GLIS2, HMGA2, IL2RB, IL3, IL3RA, INSR, JAZF1, KAT6A, MALT1, MAML2, MAST1, MAST2, MEAF6, MECOM, MET, MRTFA, MRTFB, MSMB, MUSK, NCOA2, NRG1, NUMBL, NUP214, NUP98, NUTM1, PAX8, PDGFB, PICALM, PKN1, PLAG1, PPARG, PRKACA, PRKCA, PRKCB, PTK2B, RBM15, RELA
  • RSPO2, RSPO3, RUNX1T1, SS18, STAT6, TAF15, TAL1, TCF1, TCF3, TFE3, TFEB, TFG, THADA, TLX3, TMPRSS2, TSLP, TYK2, USP6, VGLL2, YWHAE, Chr19q13.42 (C19MC)

LIS Mnemonic

COMST

Available STAT

Yes

Test Notes

Next generation sequencing (NGS) and data analysis: Nucleic acid is extracted from the patient’s sample following standard DNA and RNA extraction protocols. Extracted DNA is fragmented and tagged using SureSelect QXT target enrichment to generate adapter-tagged libraries. Biotin-labeled probes specific to the targeted regions are used for capture hybridization. Libraries are enriched for the desired regions using streptavidin beads. Enriched libraries are then indexed and pooled for sequencing. Libraries are subject to sequence analysis on Illumina NovaSeq 6000 system for 150 bp paired end reads. All coding exons and the flanking intron sequences of targeted genes in the panel are sequenced, and selected promoter regions and known intronic variants are also evaluated. Sequence data are analyzed using the home brew software ConcordS V4.0.0 and NextGENe V2 NGS Analysis Software. Sequence variants within exons and 5 bp flanking intron sequences are annotated. Copy number variation (CNV) analysis for gross deletions and duplications are evaluated using NGS data. RNA sequencing libraries are prepared using Archer Universal RNA Reagent Kit with CHOP fusion panel custom-designed primers with target specific molecular barcode. Sequencing data are analyzed using ArcherTM Analysis for fusion genes. Clinically significant variants including single nucleotide variants (SNVs), indels, CNVs and fusion genes are confirmed by Sanger sequencing, MLPA, Real-Time PCR, or ddPCR only when necessary.

Molecular Testing Notes

The genes included in the V2.1 Solid Tumor Panel (GRCh38): ABL1, ACVR1, AKT1, AKT2, AKT3, ALK, APC, AR, ARAF, ARID1A, ARID1B, ARID2, ASXL1, ATM, ATR, ATRX, AURKA, AURKB, AXIN1, AXL, B2M, BAP1, BARD1, BCL2, BCL6, BCOR, BCORL1, BLM, BRAF, BRCA1, BRCA2, BRD4, BRIP1, CARD11, CBFB, CBL, CCND1, CCND2, CCND3, CCNE1, CD274, CD79B, CDC73, CDH1, CDK12, CDK4, CDK6, CDK8, CDKN1B, CDKN2A, CDKN2B, CDKN2C, CHEK1, CHEK2, CIC, CREBBP, CRKL, CRLF2, CSF1R, CTCF, CTNNB1, DAXX, DDR2, DICER1, DNMT3A, DOT1L, EED, EGFR, EP300, EPHA3, EPHA5, EPHB1, ERBB2, ERBB3, ERBB4, ERG, ESR1, ETV6, EZH2, FANCA, FANCC, FBXW7, FGF19, FGF3, FGF4, FGFR1, FGFR2, FGFR3, FGFR4, FLCN, FLT1, FLT3, FLT4, FOXL2, FOXP1, FUBP1, GATA1, GATA2, GATA3, GNA11, GNAQ, GNAS, GRIN2A, GSK3B, HGF, HNF1A, HRAS, H1-2, H3C2, H3-3A, IDH1, IDH2, IGF1R, IKBKE, IKZF1, IL7R, INPP4B, IRF4, IRS2, JAK1, JAK2, JAK3, JMJD1C, JUN, KDM5A, KDM5C, KDM6A, KDR, KEAP1, KIT, KMT2A, KMT2C, KRAS, MAP2K1, MAP2K2, MAP2K4, MAP3K1, MAPK1, MCL1, MDM2, MDM4, MED12, MEF2B, MEN1, MET, MITF, MLH1, MPL, MRE11 (MRE11A), MSH2, MSH6, MTOR, MUTYH, MYB, MYC, MYCN, MYD88, MYOD1, NF1, NF2, NFE2L2, NKX2-1, NOTCH1, NOTCH2, NPM1, NRAS, NSD2 (WHSC1), NTRK1, NTRK2, NTRK3, PALB2, PAX5, PBRM1, PDCD1, PDGFRA, PDGFRB, PHOX2B, PIK3CA, PIK3CG, PIK3R1, PIK3R2, PIM1, PPM1D, PPP2R1A, PRDM1, PRKAR1A, PTCH1, PTEN, PTPN11, RAD50, RAD51, RAF1, RARA, RB1, RET, RHOA, RICTOR, RNF43, ROS1, RPTOR, RUNX1, SDHA, SDHB, SDHC, SDHD, SETD2, SF3B1, SMAD2, SMAD4, SMARCA4, SMARCB1, SMO, SOCS1, SOX2, SPEN, SPOP, SRC, STAG2, STK11, SUFU, SUZ12, TENT5C (FAM46C), TERT, TET2, TGFBR2, TNFAIP3, TNFRSF14, TOP1, TP53, TP63, TSC1, TSC2, TSHR, U2AF1, VHL, WT1, AMER1, and XPO1. The panel also includes coverage of the Chr19q13.42 (C19MC) region  and two cancer-associated pharmacogenomics genes (genotyping only): NUDT15 and TPMT.

The genes included in the V3 Fusion Panel (GRCh37): ABL1, ABL2, AKT3, ALK, ARHGAP26, AXL, BCL2, BCL6, BCR, BRAF, BRD3, BRD4, CAMTA1, CBFA2T3, CBFB, CCNB3, CCND1, CIC, CREBBP, CRFL2, CSF1R, DNAJB1, DUSP22, EGFR, EPC1, EPOR, ERG, ESR1, ESRRA, ETV1, ETV4, ETV5, ETV6, EWSR1, FGFR1, FGFR2, FGFR3, FGR, FOXO1, FUS, GLI1, GLIS2, HMGA2, IL2RB, IL3, IL3RA, INSR, JAK2, JAZF1, KAT6A, KMT2A, MALT1, MAML2, MAST1, MAST2, MEAF6, MECOM, MET, MRTFA, MRTFB, MSMB, MUSK, MYB, MYC, NCOA2, NOTCH1, NOTCH2, NRG1, NTRK1, NTRK2, NTRK3, NUMBL, NUP214, NUP98, NUTM1, PAX5, PAX8, PDGFB, PDGFRA, PDGFRB, PICALM, PIK3CA, PKN1, PLAG1, PPARG, PRKACA, PRKCA, PRKCB, PTK2B, RAF1, RARA, RBM15, RELA, RET, ROS1, RSPO2, RSPO3, RUNX1, RUNX1T1, SS18, STAT6, TAF15, TAL1, TCF12, TCF3, TERT, TFE3, TFEB, TFG, THADA, TLX3, TMPRSS2, TSLP, TYK2, USP6, VGLL2, YWHAE.

CPT Codes

81455
Collection

Collect

Fresh Tissue 150 mg or 0.5-2.0 cm3 fresh tissue in transport media. Deliver within 24 hours at room temperature.

Fresh Frozen Tissue 150 mg or 0.5-2.0 cm3 tissue snap frozen at -20°C. Store at -20°C. Ship on minimum of 10 lbs. of dry ice in an insulated container by overnight courier.

FFPE preferred sample: minimum six 20-um scrolls or 10 slides that are freshly cut before shipping to us via overnight delivery. It would be best to cut and ship Wednesday to arrive on Thursday. Alternatively, a whole FFPE block can be sent.

Unacceptable Conditions

Unacceptable conditions include no tumor in tissue or specimens fixed/processed in alternative fixatives.

Storage/Transport Temperature

See above.

Volume Required

See above

Minimum Required

see above

Phlebotomy Draw

No
Ordering

Performing Lab

Division of Genomic Diagnostics

Performed

Monday-Friday 9:00am - 4:00pm

Reported

21 days

Detection Rate

The Comprehensive Solid Tumor Panel includes the V2.1 Solid Tumor Panel for sequence and copy number analyses of 238 cancer genes and two genes associated with cancer pharmacogenomics, and V3 Fusion Panel which targets over 700 exons of 117 cancer genes. 

Utility

Facilitates disease diagnosis, risk stratification, and therapeutic decision-making.

Synonyms

  • Solid Tumor, Fusion panel, Comprehensive
  • COMST
  • ABL1, ACVR1, AKT1, AKT2, AKT3, ALK, APC, AR, ARAF, ARID1A, ARID1B, ARID2, ASXL1, ATM, ATR, ATRX, AURKA, AURKB, AXIN1, AXL, B2M, BAP1, BARD1, BCL2, BCL6, BCOR, BCORL1, BLM, BRAF, BRCA1, BRCA2, BRD4, BRIP1, CARD11, CBFB, CBL, CCND1, CCND2, CCND3, CCNE1, CD274, CD79B, CDC73, CDH1, CDK12, CDK4, CDK6, CDK8, CDKN1B, CDKN2A, CDKN2B, CDKN2C, CHEK1, CHEK2, CIC, CREBBP, CRKL, CRLF2, CSF1R, CTCF, CTNNB1, DAXX, DDR2, DICER1, DNMT3A, DOT1L, EED, EGFR, EP300, EPHA3, EPHA5, EPHB1, ERBB2, ERBB3, ERBB4, ERG
  • ESR1, ETV6, EZH2, FANCA, FANCC, FBXW7, FGF19, FGF3, FGF4, FGFR1, FGFR2, FGFR3, FGFR4, FLCN, FLT1, FLT3, FLT4, FOXL2, FOXP1, FUBP1, GATA1, GATA2, GATA3, GNA11, GNAQ, GNAS, GRIN2A, GSK3B, HGF, HNF1A, HRAS, H1-2, H3C2, H3-3A, IDH1, IDH2, IGF1R, IKBKE, IKZF1, IL7R, INPP4B, IRF4, IRS2, JAK1, JAK2, JAK3, JMJD1C, JUN, KDM5A, KDM5C, KDM6A, KDR, KEAP1, KIT, KMT2A, KMT2C, KRAS, MAP2K1, MAP2K2, MAP2K4, MAP3K1, MAPK1, MCL1, MDM2, MDM4, MED12, MEF2B, MEN1, MET, MITF, MLH1, MPL, MRE11 (MRE11A), MSH2, MSH6
  • MTOR, MUTYH, MYB, MYC, MYCN, MYD88, MYOD1, NF1, NF2, NFE2L2, NKX2-1, NOTCH1, NOTCH2, NPM1, NRAS, NSD2 (WHSC1), NTRK1, NTRK2, NTRK3, PALB2, PAX5, PBRM1, PDCD1, PDGFRA, PDGFRB, PHOX2B, PIK3CA, PIK3CG, PIK3R1, PIK3R2, PIM1, PPM1D, PPP2R1A, PRDM1, PRKAR1A, PTCH1, PTEN, PTPN11, RAD50, RAD51, RAF1, RARA, RB1, RET, RHOA, RICTOR, RNF43, ROS1, RPTOR, RUNX1, SDHA, SDHB, SDHC, SDHD, SETD2, SF3B1, SMAD2, SMAD4, SMARCA4, SMARCB1, SMO, SOCS1, SOX2, SPEN, SPOP, SRC, STAG2, STK11, SUFU, SUZ12, TENT5C (FAM46C)
  • TERT, TET2, TGFBR2, TNFAIP3, TNFRSF14, TOP1, TP53, TP63, TSC1, TSC2, TSHR, U2AF1, VHL, WT1, AMER1, XPO1, NUDT15, TPMT, ABL2, ARHGAP26, BCR, BRD3, CAMTA1, CBFA2T3, CCNB3, DNAJB1, DUSP22, EPOR, ESRRA, ETV1, ETV4, ETV5, EWSR1, FGR, FOXO1, FUS, GLI1, GLIS2, HMGA2, IL2RB, IL3, IL3RA, INSR, JAZF1, KAT6A, MALT1, MAML2, MAST1, MAST2, MEAF6, MECOM, MET, MRTFA, MRTFB, MSMB, MUSK, NCOA2, NRG1, NUMBL, NUP214, NUP98, NUTM1, PAX8, PDGFB, PICALM, PKN1, PLAG1, PPARG, PRKACA, PRKCA, PRKCB, PTK2B, RBM15, RELA
  • RSPO2, RSPO3, RUNX1T1, SS18, STAT6, TAF15, TAL1, TCF1, TCF3, TFE3, TFEB, TFG, THADA, TLX3, TMPRSS2, TSLP, TYK2, USP6, VGLL2, YWHAE, Chr19q13.42 (C19MC)

LIS Mnemonic

COMST

Available STAT

Yes

Test Notes

Next generation sequencing (NGS) and data analysis: Nucleic acid is extracted from the patient’s sample following standard DNA and RNA extraction protocols. Extracted DNA is fragmented and tagged using SureSelect QXT target enrichment to generate adapter-tagged libraries. Biotin-labeled probes specific to the targeted regions are used for capture hybridization. Libraries are enriched for the desired regions using streptavidin beads. Enriched libraries are then indexed and pooled for sequencing. Libraries are subject to sequence analysis on Illumina NovaSeq 6000 system for 150 bp paired end reads. All coding exons and the flanking intron sequences of targeted genes in the panel are sequenced, and selected promoter regions and known intronic variants are also evaluated. Sequence data are analyzed using the home brew software ConcordS V4.0.0 and NextGENe V2 NGS Analysis Software. Sequence variants within exons and 5 bp flanking intron sequences are annotated. Copy number variation (CNV) analysis for gross deletions and duplications are evaluated using NGS data. RNA sequencing libraries are prepared using Archer Universal RNA Reagent Kit with CHOP fusion panel custom-designed primers with target specific molecular barcode. Sequencing data are analyzed using ArcherTM Analysis for fusion genes. Clinically significant variants including single nucleotide variants (SNVs), indels, CNVs and fusion genes are confirmed by Sanger sequencing, MLPA, Real-Time PCR, or ddPCR only when necessary.

Molecular Testing Notes

The genes included in the V2.1 Solid Tumor Panel (GRCh38): ABL1, ACVR1, AKT1, AKT2, AKT3, ALK, APC, AR, ARAF, ARID1A, ARID1B, ARID2, ASXL1, ATM, ATR, ATRX, AURKA, AURKB, AXIN1, AXL, B2M, BAP1, BARD1, BCL2, BCL6, BCOR, BCORL1, BLM, BRAF, BRCA1, BRCA2, BRD4, BRIP1, CARD11, CBFB, CBL, CCND1, CCND2, CCND3, CCNE1, CD274, CD79B, CDC73, CDH1, CDK12, CDK4, CDK6, CDK8, CDKN1B, CDKN2A, CDKN2B, CDKN2C, CHEK1, CHEK2, CIC, CREBBP, CRKL, CRLF2, CSF1R, CTCF, CTNNB1, DAXX, DDR2, DICER1, DNMT3A, DOT1L, EED, EGFR, EP300, EPHA3, EPHA5, EPHB1, ERBB2, ERBB3, ERBB4, ERG, ESR1, ETV6, EZH2, FANCA, FANCC, FBXW7, FGF19, FGF3, FGF4, FGFR1, FGFR2, FGFR3, FGFR4, FLCN, FLT1, FLT3, FLT4, FOXL2, FOXP1, FUBP1, GATA1, GATA2, GATA3, GNA11, GNAQ, GNAS, GRIN2A, GSK3B, HGF, HNF1A, HRAS, H1-2, H3C2, H3-3A, IDH1, IDH2, IGF1R, IKBKE, IKZF1, IL7R, INPP4B, IRF4, IRS2, JAK1, JAK2, JAK3, JMJD1C, JUN, KDM5A, KDM5C, KDM6A, KDR, KEAP1, KIT, KMT2A, KMT2C, KRAS, MAP2K1, MAP2K2, MAP2K4, MAP3K1, MAPK1, MCL1, MDM2, MDM4, MED12, MEF2B, MEN1, MET, MITF, MLH1, MPL, MRE11 (MRE11A), MSH2, MSH6, MTOR, MUTYH, MYB, MYC, MYCN, MYD88, MYOD1, NF1, NF2, NFE2L2, NKX2-1, NOTCH1, NOTCH2, NPM1, NRAS, NSD2 (WHSC1), NTRK1, NTRK2, NTRK3, PALB2, PAX5, PBRM1, PDCD1, PDGFRA, PDGFRB, PHOX2B, PIK3CA, PIK3CG, PIK3R1, PIK3R2, PIM1, PPM1D, PPP2R1A, PRDM1, PRKAR1A, PTCH1, PTEN, PTPN11, RAD50, RAD51, RAF1, RARA, RB1, RET, RHOA, RICTOR, RNF43, ROS1, RPTOR, RUNX1, SDHA, SDHB, SDHC, SDHD, SETD2, SF3B1, SMAD2, SMAD4, SMARCA4, SMARCB1, SMO, SOCS1, SOX2, SPEN, SPOP, SRC, STAG2, STK11, SUFU, SUZ12, TENT5C (FAM46C), TERT, TET2, TGFBR2, TNFAIP3, TNFRSF14, TOP1, TP53, TP63, TSC1, TSC2, TSHR, U2AF1, VHL, WT1, AMER1, and XPO1. The panel also includes coverage of the Chr19q13.42 (C19MC) region  and two cancer-associated pharmacogenomics genes (genotyping only): NUDT15 and TPMT.

The genes included in the V3 Fusion Panel (GRCh37): ABL1, ABL2, AKT3, ALK, ARHGAP26, AXL, BCL2, BCL6, BCR, BRAF, BRD3, BRD4, CAMTA1, CBFA2T3, CBFB, CCNB3, CCND1, CIC, CREBBP, CRFL2, CSF1R, DNAJB1, DUSP22, EGFR, EPC1, EPOR, ERG, ESR1, ESRRA, ETV1, ETV4, ETV5, ETV6, EWSR1, FGFR1, FGFR2, FGFR3, FGR, FOXO1, FUS, GLI1, GLIS2, HMGA2, IL2RB, IL3, IL3RA, INSR, JAK2, JAZF1, KAT6A, KMT2A, MALT1, MAML2, MAST1, MAST2, MEAF6, MECOM, MET, MRTFA, MRTFB, MSMB, MUSK, MYB, MYC, NCOA2, NOTCH1, NOTCH2, NRG1, NTRK1, NTRK2, NTRK3, NUMBL, NUP214, NUP98, NUTM1, PAX5, PAX8, PDGFB, PDGFRA, PDGFRB, PICALM, PIK3CA, PKN1, PLAG1, PPARG, PRKACA, PRKCA, PRKCB, PTK2B, RAF1, RARA, RBM15, RELA, RET, ROS1, RSPO2, RSPO3, RUNX1, RUNX1T1, SS18, STAT6, TAF15, TAL1, TCF12, TCF3, TERT, TFE3, TFEB, TFG, THADA, TLX3, TMPRSS2, TSLP, TYK2, USP6, VGLL2, YWHAE.
Result Interpretation
Administrative

CPT Codes

81455