CANCER TEST
CARCINOMA OF UNKNOWN PRIMARY (CUP)
TO.T.A.L.
Information
Questions
Turn Around Time:
TO.T.A.L: 2 weeks*
* In case additional enrichment of the material is required, for the successful results of the tests, we will contact you.
I Choose TO.T.A.L.
TO.T.A.L. is a panel of genes and biomarkers that provides the most comprehensive picture of a tumor’s genomic signature. It serves as an indication for the application of personalized therapeutic options such as targeted therapy, immunotherapy, PARP inhibitors or chemotherapy. It can be used for the application of second- or third-line therapy, in tumors of unknown primary and in any solid tumor, regardless of rarity or histological type.
TO.T.A.L. focuses on essential, non-redundant information about genes whose role in cancer has not been clarified or are not clinically targetable.
It includes all tumor agnostic biomarkers, such as TMB, MSI/MMR, PD-L1, NTRK1, NTRK2, NTRK3 fusions, HER2 amplification, BRAF V600E, RET fusions, FGFR1, FGFR2, FGFR3 fusions, as well as testing for BRCA1, BRCA2 genes, HRD score, testing for 410 genes for point mutations SNVs/INDELs and testing for 49 genes for rearrangements (fusions).
Consult your Oncologist for the best choice and personalization for you. There is the possibility of further personalization of the tests.
In case your sample is not already at Microdiagnostics archive, please contact us immediately so that we can arrange for its safe and rapid transport to our laboratory. You will also need to quickly and easily complete the Consent Form.
The number and type of mutations examined is updated through a dynamic process in accordance with current scientific research. It should therefore be recognized that there is a possibility that the list of genes on the order form may have changed (genes added or removed) during the analysis of the sample in the laboratory.
Main objectives and uses of TO.T.A.L.:
- Detection of genetic alterations regardless of tissue of origin
- E.g. mutations in NTRK fusions, MSI-H, TMB-high, BRCA1/2 , which can guide treatment in different cancers.
- Personalized treatment guidance (precision oncology)
- Patients can receive targeted therapies (e.g. TRK inhibitors, PARP inhibitors, immunotherapy) if a positive biomarker is found, regardless of where the tumor is located.
- Clinical trial optimization
- It is used to enroll patients in basket trials , where selection is based on molecular characteristics rather than tumor type.
- Economy and speed
- A gene panel can examine dozens or hundreds of biomarkers simultaneously instead of multiple individual tests.
- Discovery of new targets
- Through big data analysis, new mutations or combinations of biomarkers with prognostic or therapeutic value may be identified.
The tests are performed on the surgical specimen (paraffin cubes) or the biopsy material (paraffin cube) from which your histological examination was performed or on the aspiration material (FNAB, EBUS) from which your cytological examination was performed. In our fully integrated Laboratory, the pathologist selects the most appropriate & representative paraffin cube, ensuring that the most appropriate sample will be used for the tests. Qualitative and quantitative parameters are checked.
In case your sample is not already at Microdiagnostics archive, please contact us immediately so that we can arrange for its safe and rapid transport to our laboratory. You will also need to quickly and easily complete the Consent Form.
In our fully integrated Laboratory, we handle your sample in such a way as to minimize its unnecessary waste:
- The paraffin cube is placed, if possible, once on the microtome for obtaining tissue sections, by experienced tissue technologists.
- Tissue sections are obtained sequentially in such a way as to ensure diagnosis and perform Immunohistochemistry if required.
- Ensuring preservation of tissue sections for further molecular examinations.
- Pathologists perform microdissection to ensure the maximum amount of cancer cells possible, removing all other necrotic cells or normal tissue that could affect the validity of the results.
- The molecular biologist immediately processes the tissue in a fully controlled environment, using next-generation sequencing (NGS) or real-time polymerase chain reaction (Real-time PCR) to identify mutations in the genes of interest.
Frequently Asked Questions (FAQ)
TO.T.A.L. is a test-tool that allows for the comprehensive molecular mapping of cancer , in order to provide targeted treatments that are not limited to the histological type, but to the genetic profile of the tumor.
The tests are performed on the surgical specimen (paraffin cubes) or the biopsy material (paraffin cube) from which your histological examination was performed or on the aspiration material (FNAB, EBUS) from which your cytological examination was performed. In our fully integrated Laboratory, the pathologist selects the most appropriate & representative paraffin cube, ensuring that the most appropriate sample will be used for the tests. Qualitative and quantitative parameters are checked.
In case your sample is not already at Microdiagnostics archive, please contact us immediately so that we can arrange for its safe and rapid transport to our laboratory. You will also need to quickly and easily complete the Consent Form.
Most of the time, the sample material we are called upon to handle is small because it has resulted from a minimally invasive method (needle biopsy, fluid aspiration, paraffin block with minimal material).
In our laboratory, Pathologists check in a timely manner whether the material to be examined is sufficient. If so, then a management algorithm is followed, with the aim of achieving the performance of multiple tests on the material (Immunohistochemistry, real-time PCR, NGS) in order to fully check the molecular profile of your tumor (proteins, genes, histological Grading).
In this case, and once sample enrichment manipulations have been exhausted, we contact your clinician to discuss alternative approaches in order to obtain the desired information to select the optimal treatment for you. Some examples:
- Performing an alternative test (e.g. Immunohistochemistry instead of PCR, or choosing Next Generation Sequencing (NGS))
- Performing Immunohistochemistry instead of FISH (Fluorescent In Situ Hybridization) and tubulin
- Possible blood sampling instead of tissue testing (liquid biopsy)
- Possible option to take a new biopsy or puncture
Contact us at 2310 23 22 72 and we will immediately assist you in quickly transporting the sample to our laboratory.
By cash, bank card, bank deposit, or Online interbank deposit.
One of the primary concerns at Microdiagnostics is the protection of your personal data as well as the strict observance of the conditions for the protection of your genetic material and medical results.
In full compliance with the General Data Protection Regulation (GDPR), we ensure that any examination conducted is done with your knowledge and consent and we do not communicate results over the phone.