Tissue
A physician may choose to use FoundationOne CDx vs FoundationOne Liquid CDx in this instance
Tissue is available and adequate for sequencing
2 key advantages of FoundationOne Liquid CDx vs FoundationOne CDx (tissue)
2) Can be used when tissue is unavailable
At Foundation Medicine, "MRD" is an acronym for this
Molecular Residual Disease
Immunohistochemistry (IHC) testing primarily evaluates the presence of this substance
gene protein expression in tissue
FoundationOne Liquid CDx report with a ctDNA "low" is most helpful in this instance
No genomic driver alterations are present
3 genomic signatures reported with FoundationOne CDx tes
Tumor Mutation Burden (TMB), Microsatellite Instability (MSI), Homologous Recombination Deficiency Signature (HRD Sig)
Micro Satellite Instability High (MSI-H) and blood based Tumor Mutation Burden (bTMB)
FoundationOne MRD focuses on this type of genomic alterations
Structural Variants (SVs)
The most common use of IHC testing is to detect this marker
PD-L1 protein expression
One advantage of tissue-based testing vs liquid biopsy
Ability to directly analyze DNA from the tumor itself
How Tumor Mutational Burden (TMB) is reported
Mutations per megabase
FoundationOne Liquid CDx analyzes this blood component
Circulating tumor DNA (ctDNA) from cell-free DNA
FoundationOne MRD demonstrated this median lead time over imaging for recurrence detection
13.7 months
IHC testing is performed exclusively on this sample type
tissue
1) Targeted therapy
2) Immunotherapy
3) Medical trial eligibility
4 classes of genomic alterations detected by FoundationOne CDx
Substitutions, Insertions and deletions (indels), copy number alterations, rearrangements
A ctDNA low tumor fraction commonly suggest this
Low levels of circulating tumor DNA
FoundationOne MRD utilizes these two technologies
Tissue-based Whole exome sequencing and digital PCR
IHC testing for eligibility for immunotherapy
PD-L1
DAILY DOUBLE! Structural Variants are important in MRD testing for primarily 3 reasons
1) Stable across tumor evolution
2) Resistant to errors
3) Lower failure rate
Specimen requirements for FoundationOne CDx tissue testing (2 answers)
1) Formalin-Fixed block (FFPE)
2) 10 unstained slides + 1 H&E slide
0.0001
This is the current patient focus for FoundationOne MRD
Stage II and Stage III breast cancer
Why an FMI customer might order both CGP (tissue or liquid testing) and add on IHC
To provide complementary genomic information about a gene alteration/gene protein expression to determine treatment options
Foundation Medicine's tissue Micro-Precision Enrichment provides this operational advantage
Reduces QNS rates (quantity not sufficient)