Dr. Garyfalia Karponi
What it is
TO.T.A.L. is a gene and biomarker panel that provides a comprehensive overview of the molecular signature of a tumor. It serves as an indication for the application of personalized therapeutic options, such as targeted therapy, immunotherapy, PARP inhibitors or chemotherapy.
Where it can be used
In tumors of unknown primary
In any solid tumor, regardless of rarity
For the application of second- or third-line therapy
What it includes
| Biomarker/Gene | Method | Indication |
| TMB | NGS | Immunotherapy |
| MSI/MMR | Real-Time PCR/IHC | Immunotherapy |
| PD-L1 | IHC | Immunotherapy |
| HRD score | NGS | PARP inhibitors |
| BRCA1, BRCA2 | NGS | PARP inhibitors |
| HER2 amplification | FISH | Targeted therapy |
| 410 genes (point SNVs, INDELs) | NGS | Targeted therapy/Immunotherapy |
| 49 genes (fusions) | NGS | Targeted therapy |
Usefulness
Focus on what is essential. No unnecessary information about genes whose role in cancer has not been clarified or which are not clinically targetable.
Includes all tumor-agnostic biomarkers:
| Biomarker/Gene | Indication |
| TMB | Pembrolizumab |
| MSI/MMR | Pembrolizumab, Dostarlimab |
| PD-L1 | Pembrolizumab |
| NTRK1, NTRK2, NTRK3 fusions | Larotrectinib, Entrectinib, Repotrectinib |
| HER2 amplification | Trastuzumab |
| BRAF V600E | Dabrafenib, Trametinib |
| RET fusions | Selpercatinib |
Required sample: FFPE tissue block or cell block
Turnaround time: 3–4 weeks
Please contact us for more information.
Garyfalia Karponi, MSc, PhD
Molecular Biologist-Geneticist
Chief Scientific Officer, Department of Molecular Diagnostics