MI Tumor Seek (test by NGS), plus PD-L1, plus MMR testing.
PD-1 (test by IHC) is an immunosuppressive protein molecule that is upregulated on activated T-cells and other immune cells. It is activated by binding to its ligand, PD-L1, an action that results in intracellular responses that reduce T-cell activation. Reports of aberrant PD-L1 expression in cancer cells have spurred the development of PD-1 and PD-L1 inhibitors. The U.S. Food and Drug Administration (FDA) recently approved an anti-PD-1 therapy, pembrolizumab (Keytruda), for the treatment of advanced or unresectable melanoma. Another anti-PD-1 agent, nivolumab, was recently approved in Japan for the treatment of unresectable melanoma.
MMR genes create a system for recognizing and repairing mistakes that arise during DNA replication. If the MMR genes themselves become damaged or mutated, they will not work properly and the mistakes made during replication will not be repaired. This leaves the cell vulnerable and unhealthy. Cells without normal MMR genes can develop more and more mistakes with each new copy, resulting in a normal healthy cell losing the ability to stop dividing, or growing, once it has appropriately replaced itself. The ability to stop dividing, or growing, is what causes a colon cell to become cancerous.
Test List In Profile:
All Biomarker Analysis includes:
DNA Mutation, Copy Number Alterations, Insertions/Deletions
Genomic Signatures: MSI, TMB
RNA Fusion Analysis
IHC: PD-L1, MMR