FLT3 exon 14 ins
|
acute myeloid leukemia
|
sensitive
|
Sorafenib
|
Guideline |
Actionable |
Nexavar (sorafenib) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
MSH2 negative
|
follicular thyroid carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with follicular thyroid carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) after progression on prior treatment (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Cisplatin + Ipilimumab + Nivolumab + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Platinol (cisplatin), Alimta (pemetrexed), Opdivo (nivolumab), and Yervoy (ipilimumab) is in guidelines as first-line therapy for patients with advanced or metastatic lung adenocarcinoma with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MSH6 negative
|
breast cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines for patients with metastatic or unresectable breast cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) who have progressed on or following prior treatment (NCCN.org).
|
detail...
|
BRAF V600E
|
rectum cancer
|
sensitive
|
Encorafenib + Panitumumab
|
Guideline |
Actionable |
Braftovi (encorafenib) in combination with Vectibix (panitumumab) is included in guidelines as primary or subsequent therapy for patients with rectal cancer harboring BRAF V600E (NCCN.org).
|
detail...
|
MSH6 negative
|
stomach cancer
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
small intestine adenocarcinoma
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Atezolizumab + Carboplatin + Nab-paclitaxel
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Abraxane (nab-paclitaxel), and Tecetriq (atezolizumab) is in guidelines as first-line therapy for patients with lung adenocarcinoma with CD274 (PD-L1) expression of greater than or equal to 1%, and negative status for EGFR, ALK, ROS1, BRAF, RET, and MET exon 14 skipping mutations (NCCN.org).
|
detail...
|
IDH2 mutant
|
acute myeloid leukemia
|
sensitive
|
Azacitidine + Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) in combination with Vidaza (azacitidine) is included in guidelines for adult patients with acute myeloid leukemia harboring an IDH2 mutation (NCCN.org).
|
detail...
|
BRAF L597X
|
melanoma
|
sensitive
|
Trametinib
|
Guideline |
Actionable |
Mekinist (trametinib) is included in guidelines as second-line therapy for metastatic or unresectable cutaneous melanoma patients with BRAF L597 mutations (NCCN.org).
|
detail...
|
IDH1 mutant
|
anaplastic astrocytoma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
IDH1 mutations aid in the diagnosis of grade III astrocytomas (NCCN.org).
|
detail...
|
IDH1 mutant
|
acute myeloid leukemia
|
sensitive
|
Ivosidenib
|
Guideline |
Actionable |
Tibsovo (ivosidenib) is included in guidelines for patients with relapsed or refractory acute myeloid leukemia harboring an IDH1 mutation (NCCN.org).
|
detail...
|
FGFR1 rearrange
|
myeloid and lymphoid neoplasms associated with FGFR1 abnormalities
|
sensitive
|
Pemigatinib
|
Guideline |
Actionable |
Pemazyre (pemigatinib) is included in guidelines (category 2A) for patients with a myeloid/lymphoid neoplasm with eosinophilia harboring an FGFR1 rearrangement (NCCN.org).
|
detail...
|
FLT3 exon21
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Idarubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Idarubicin and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MLH1 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
esophagus adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line, second-line, or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) esophageal adenocarcinoma that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
IDH1 mutant
|
high grade glioma
|
not applicable
|
N/A
|
Guideline |
Prognostic |
IDH1 mutations are associated with a favorable prognosis in patients with glioma, and are associated with a survival benefit for patients treated with radiation or alkylator therapy (NCCN.org).
|
detail...
|
POLD1 inact mut
|
colon cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as systemic therapy for patients with advanced or metastatic colon cancer harboring POLD1 inactivating mutations (NCCN.org).
|
detail...
|
ALK rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Durvalumab
|
Guideline |
Actionable |
Immune checkpoint inhibitors including Opdivo (nivolumab), Keytruda (pembrolizumab), Tecentriq (atezolizumab), and Imfinzi (durvalumab) are not indicated for use as subsequent therapy in non-small cell lung cancer patients with ALK rearrangement (NCCN.org).
|
detail...
|
NRAS exon3
|
rectum cancer
|
resistant
|
Panitumumab
|
Guideline |
Actionable |
Vectibix (panitumumab) is not indicated for use in rectum cancer patients with NRAS exon 3 mutations (NCCN.org).
|
detail...
|
VHL inact mut
|
renal cell carcinoma
|
sensitive
|
Belzutifan
|
Guideline |
Actionable |
Welireg (belzutifan) is included in guidelines for patients with Von Hippel-Lindau disease-associated renal cell carcinoma that do not require immediate surgery (NCCN.org).
|
detail...
|
TP53 mutant
|
myelodysplastic syndrome
|
not applicable
|
N/A
|
Guideline |
Prognostic |
TP53 mutations except P47S and P72R are associated with a poor prognosis in patients with myelodysplastic syndrome (NCCN.org).
|
detail...
|
MSH2 negative
|
colon cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as preferred primary or subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH1 mutant
|
acute myeloid leukemia
|
sensitive
|
Azacitidine + Ivosidenib
|
Guideline |
Actionable |
Tibsovo (ivosidenib) in combination with Vidaza (azacitidine) is included in guidelines. (category 1) for patients with relapsed or refractory acute myeloid leukemia harboring an IDH1 mutation (NCCN.org).
|
detail...
|
KMT2A rearrange
|
childhood B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
KMT2A rearrangements are associated with a poor prognosis in pediatric patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
MSH2 negative
|
rectum cancer
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as a primary therapy for advanced or metastatic rectum cancer patients with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
chondrosarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic chondrosarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
POLE inact mut
|
colon cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for patients with advanced or metastatic colon cancer harboring POLE inactivating mutations (NCCN.org).
|
detail...
|
PMS2 negative
|
Ewing sarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic Ewing sarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF V600K
|
skin melanoma
|
sensitive
|
Dabrafenib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) therapy is included in guidelines for cutaneous melanoma patients with unresectable or metastatic disease harboring BRAF V600 activating mutations, such as BRAF V600K, in cases where BRAF/MEK inhibitor combination therapy is contraindicated (NCCN.org).
|
detail...
|
MSH2 negative
|
esophagus adenocarcinoma
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Carboplatin + Durvalumab + Nab-paclitaxel + Tremelimumab
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Abraxane (nab-paclitaxel), Imfinzi (durvalumab), and Imjudo (tremelimumab) is in guidelines as first-line therapy for patients with advanced or metastatic lung adenocarcinoma, with CD274 (PD-L1) expression >/=1% - 49% (category 1) or >/= 50% (category 2B), and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
BRAF V600E
|
pilocytic astrocytoma
|
sensitive
|
Cobimetinib + Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) and Cotellic (cobimetinib) combination therapy is included in guidelines as an adjuvant treatment for patients with pilocytic astrocytoma harboring BRAF V600E (NCCN.org).
|
detail...
|
PMS2 negative
|
ampulla of Vater adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for metastatic ampullary adenocarcinoma patients with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
pancreatic adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with locally advanced, metastatic, or recurrent pancreatic adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) who have not received prior immunotherapy (NCCN.org).
|
detail...
|
ROS1 rearrange
|
lung non-small cell carcinoma
|
sensitive
|
Lorlatinib
|
Guideline |
Actionable |
Lorbrena (lorlatinib) is included in guidelines as subsequent therapy in patients with advanced or metastatic ROS1-rearranged non-small lung cancer (NCCN.org).
|
detail...
|
FLT3 exon 14 ins
|
myelodysplastic syndrome
|
not applicable
|
N/A
|
Guideline |
Prognostic |
FLT3 internal tandem duplication (FLT3-ITD) mutations are associated with poor prognosis in patients with myelodysplastic syndrome (NCCN.org).
|
detail...
|
CD274 over exp
|
lung squamous cell carcinoma
|
sensitive
|
Atezolizumab
|
Guideline |
Actionable |
Tecentriq (atezolizumab) is in guidelines as preferred first-line therapy for patients with advanced or metastatic lung squamous cell carcinoma with CD274 (PD-L1) expression of 50% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MSH6 negative
|
neuroendocrine tumor
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) locally advanced or metastatic well-differentiated, Grade 3 neuroendocrine tumors or unresectable or metastatic extrapulmonary poorly differentiated neuroendocrine carcinoma, large or small cell carcinoma, or mixed neuroendocrine/non-neuroendocrine neoplasms who have progressed on or following prior treatment (NCCN.org).
|
detail...
|
MSH6 negative
|
oncocytic carcinoma of the thyroid
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with Hurthle cell thyroid carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) after progression on prior treatment (NCCN.org).
|
detail...
|
BRAF V600E
|
follicular thyroid carcinoma
|
sensitive
|
Dabrafenib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) is included in guidelines for patients with recurrent, advanced, or metastatic thyroid follicular carcinoma harboring BRAF V600E for whom clinical trials are not available or appropriate (NCCN.org).
|
detail...
|
MLH1 negative
|
gallbladder cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as primary therapy and subsequent-line therapy for patients with unresectable or metastatic biliary tract cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including gallbladder cancer (NCCN.org).
|
detail...
|
CD274 positive
|
esophagus adenocarcinoma
|
sensitive
|
Capecitabine + Cisplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with first-line chemotherapy including Xeloda (capecitabine) and Platinol (cisplatin) is included in guidelines as preferred first-line therapy for patients with locally advanced, recurrent, or metastatic ERBB2 (HER2) overexpression-negative esophageal adenocarcinoma expressing PD-L1 (CD274) with CPS >/= 10 (category 1) or with CPS >/= 1 and <10 (category 2B) (NCCN.org).
|
detail...
|
IDH2 mutant
|
oligodendroglioma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
IDH2 mutations aid in the diagnosis of oligodendrogliomas (NCCN.org).
|
detail...
|
CD274 positive
|
vaginal carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as preferred second-line or subsequent therapy for patients with recurrent or metastatic vaginal squamous cell carcinoma or adenocarcinoma with CD274 (PD-L1) expression (CPS >/= 1) (NCCN.org).
|
detail...
|
PMS2 negative
|
chordoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic chordoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
RET fusion
|
hepatocellular carcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as subsequent-line therapy (category 2B) for patients with hepatocellular carcinoma harboring RET fusions (NCCN.org).
|
detail...
|
ALK rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Osimertinib
|
Guideline |
Actionable |
EGFR tyrosine kinase inhibitors including Tarceva (erlotinib), Iressa (gefitinib), Gilotrif (afatinib), and Tagrisso (osimertinib) are not indicated for use as subsequent therapy in ALK rearranged non-small cell lung cancer patients who relapsed on Alecensa (alectinib), Xalkori (crizotinib), or Zykadia (ceritinib) (NCCN.org).
|
detail...
|
ATR inact mut
|
prostate cancer
|
sensitive
|
Enzalutamide + Talazoparib
|
Guideline |
Actionable |
Talzenna (talazoparib) plus Xtandi (enzalutamide) is included in guidelines as systemic therapy for patients with metastatic castration-resistant prostate cancer harboring a pathogenic germline or somatic ATR mutation who have not been treated in the setting of castration-resistant prostate cancer (NCCN.org).
|
detail...
|
MSH6 negative
|
penile cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as subsequent-line systemic therapy for metastatic/recurrent penile cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF V600E
|
ganglioglioma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Combination of Mekinist (trametinib) and Tafinlar (dabrafenib) is included in guidelines as an adjuvant treatment for patients with ganglioglioma harboring BRAF V600E (NCCN.org).
|
detail...
|
MSH2 negative
|
colon cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as primary or subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
sarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for soft tissue sarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), regardless of sarcoma sub-type (NCCN.org).
|
detail...
|
KMT2A rearrange
|
childhood T-cell acute lymphoblastic leukemia
|
sensitive
|
Revumenib
|
Guideline |
Actionable |
Revuforj (revumenib) is included in guidelines for pediatric patients with relapsed or refractory T-cell acute lymphoblastic leukemia harboring a KMT2A rearrangement (NCCN.org).
|
detail...
|
BRAF V600E
|
rectum cancer
|
resistant
|
Cetuximab
|
Guideline |
Actionable |
Erbitux (cetuximab), as a monotherapy, is not indicated for use in rectum cancer patients with BRAF V600E (NCCN.org).
|
detail...
|
BRAF fusion
|
skin melanoma
|
sensitive
|
Trametinib
|
Guideline |
Actionable |
Mekinist (trametinib) is included in guidelines as second-line therapy for metastatic or unresectable cutaneous melanoma patients with BRAF fusions (NCCN.org).
|
detail...
|
RET rearrange
|
lung non-small cell carcinoma
|
sensitive
|
Cabozantinib
|
Guideline |
Actionable |
Cometriq (cabozantinib) is in guidelines as a first-line and subsequent therapy for patients with advanced or metastatic non-small cell lung cancer harboring RET rearrangements (NCCN.org).
|
detail...
|
FLT3 exon21
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Cytosar-U (cytarabine) is included in guidelines as consolidation therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
IDH1 mutant
|
myelofibrosis
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
IDH1 mutations aid in the diagnosis of primary myelofibrosis in the absence of JAK2, CALR, or MPL mutations (NCCN.org).
|
detail...
|
NRAS wild-type
|
rectum cancer
|
predicted - sensitive
|
Panitumumab
|
Guideline |
Actionable |
Vecitbix (panitumumab), alone and in combination with chemotherapy, is included in guidelines for patients with advanced or metastatic rectal cancer that is BRAF wild-type, KRAS wild-type, and NRAS wild-type (NCCN.org).
|
detail...
|
CD274 positive
|
gastric adenocarcinoma
|
sensitive
|
Cisplatin + Fluorouracil + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with a fluoropyrimidine (Adrucil (fluorouracil) or Xeloda (capecitabine)) and platinum-containing chemotherapy (Platinol (cisplatin) or Eloxatin (oxaliplatin)) is included in guidelines as a preferred first-line therapy for patients with locally advanced, unresectable, or metastatic gastric adenocarcinoma expressing CD274 (PD-L1, CPS>/=10; category 1) or CD274 (PD-L1, CPS>/=1 and <10; category 2B) and without ERBB2 (HER2) overexpression (NCCN.org).
|
detail...
|
FLT3 exon18
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Idarubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Idamycin (idarubicin) and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
NRAS wild-type
|
colon cancer
|
predicted - sensitive
|
Panitumumab
|
Guideline |
Actionable |
Vectibix (panitumumab), alone and in combination with chemotherapy, is included in guidelines for patients with advanced or metastatic colon cancer that is BRAF wild-type, KRAS wild-type, and NRAS wild-type (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Duvelisib
|
Guideline |
Actionable |
Copiktra (duvelisib) is indicated in the guidelines as second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
FLT3 exon16
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin), in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine), is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MSH6 negative
|
esophagus adenocarcinoma
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
ovary epithelial cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 mutant
|
colon cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Lynch syndrome results from germline mutations in DNA mismatch repair genes including MLH1, MSH2, MSH6, and PMS2, and is associated with increased risk of developing colon cancer (NCCN.org).
|
detail...
|
POLE inact mut
|
colon cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as systemic therapy for patients with advanced or metastatic colon cancer harboring POLE inactivating mutations (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
acute myeloid leukemia
|
sensitive
|
Azacitidine + Sorafenib
|
Guideline |
Actionable |
Nexavar (sorafenib) in combination with Vidaza (azacitidine) is included in guidelines for patients with relapsed or refractory acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Atezolizumab + Bevacizumab + Carboplatin + Paclitaxel
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Taxol (paclitaxel), Avastin (bevacizumab), and Tecentriq (atezolizumab) is in guidelines as first-line therapy for patients with advanced or metastartic non-small cell lung cancer, not otherwise specified, with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
PMS2 negative
|
stomach cancer
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
small intestine adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
stomach cancer
|
sensitive
|
Durvalumab + Tremelimumab
|
Guideline |
Actionable |
Imfinzi (durvalumab), in combination with Imjudo (tremelimumab, is included in guidelines as neoadjuvant therapy for patients with gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
JAK3 mutant
|
B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
JAK3 mutations are associated with a poor prognosis in patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
IDH1 mutant
|
acute myeloid leukemia
|
sensitive
|
Azacitidine
|
Guideline |
Actionable |
Vidaza (azacitidine) is included in guidelines for adult patients with acute myeloid leukemia harboring an IDH1 mutation (NCCN.org).
|
detail...
|
CD274 positive
|
lung squamous cell carcinoma
|
sensitive
|
Carboplatin + Nab-paclitaxel + Pembrolizumab
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Abraxane (nab-paclitaxel), and Keytruda (pembrolizumab) is in guidelines as preffered first-line therapy for patients with advanced or metastatic lung squamous cell carcinoma with CD274 (PD-L1) expression of greater than or equal to 1% and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
IDH1 act mut
|
oligodendroglioma
|
sensitive
|
Vorasidenib
|
Guideline |
Actionable |
Voranigo (vorasidenib) is included in guidelines as adjuvant therapy for patients with WHO grade 2 or 3 1p19q codeleted oligodendroglioma harboring an IDH1 activating mutation (NCCN.org).
|
detail...
|
MSH6 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH2 act mut
|
oligodendroglioma
|
sensitive
|
Vorasidenib
|
Guideline |
Actionable |
Voranigo (vorasidenib) is included in guidelines as adjuvant therapy for patients with WHO grade 2 or 3 1p19q codeleted oligodendroglioma harboring an IDH2 activating mutation (NCCN.org).
|
detail...
|
BRAF wild-type
|
colon cancer
|
predicted - sensitive
|
Cetuximab
|
Guideline |
Actionable |
Erbitux (cetuximab), alone and in combination with chemotherapy, is included in guidelines for patients with advanced or metastatic colon cancer that is BRAF wild-type, KRAS wild-type, and NRAS wild-type (NCCN.org).
|
detail...
|
ROS1 rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Alectinib
|
Guideline |
Actionable |
Alecensa (alectinib) is not indicated for use in ROS1 rearranged non-small cell lung cancer patients whose disease became resistant to Xalkori (crizotinib) (NCCN.org).
|
detail...
|
PMS2 negative
|
endometrial carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line or subsequent-line therapy for patients with recurrent or metastatic endometrial carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
esophagus adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
gastric adenocarcinoma
|
sensitive
|
Capecitabine + Cisplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with a fluoropyrimidine (Xeloda (capecitabine) or Adrucil (fluorouracil)) and platinum-containing chemotherapy (Platinol (cisplatin) or Eloxatin (oxaliplatin)) is included in guidelines as a preferred first-line therapy for patients with locally advanced, unresectable, or metastatic gastric adenocarcinoma expressing CD274 (PD-L1, CPS>/=10; category 1) or CD274 (PD-L1, CPS>/=1 and <10; category 2B) and without ERBB2 (HER2) overexpression (NCCN.org).
|
detail...
|
FLT3 exon21
|
acute myeloid leukemia
|
sensitive
|
Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
BRAF V600E
|
oncocytic carcinoma of the thyroid
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
The combination of Tafinlar (dabrafenib) and Mekinist (trametinib) is included in guidelines for patients with thryoid Hürthle cell carcinoma harboring BRAF V600E who have progressed on therapy and have no further treatment options (NCCN.org).
|
detail...
|
CD274 positive
|
esophageal cancer
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with first-line chemotherapy including Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as preferred first-line therapy for patients with locally advanced, recurrent, or metastatic ERBB2 (HER2) overexpression negative esophageal adenocarcinoma expressing PD-L1 (CD274) with CPS >/= 10 (category 1) or with CPS <10 (category 2B) (NCCN.org).
|
detail...
|
PMS2 negative
|
small intestine adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
RET fusion
|
anaplastic thyroid carcinoma
|
sensitive
|
Pralsetinib
|
Guideline |
Actionable |
Gavreto (pralsetinib) is included in guidelines as systemic therapy for patients with anaplastic thyroid carcinoma harboring RET fusions (NCCN.org).
|
detail...
|
FLT3 exon15
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin), in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine), is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
IDH2 act mut
|
oligodendroglioma
|
sensitive
|
Ivosidenib
|
Guideline |
Actionable |
Tibsovo (ivosidenib) is included in guidelines for patients with oligodendroglioma harboring an IDH2 activating mutation (NCCN.org).
|
detail...
|
MLH1 negative
|
colon cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
RET fusion
|
Squamous Cell Carcinoma of Unknown Primary
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines for patients with squamous cell carcinoma of unknown primary harboring RET fusions (NCCN.org).
|
detail...
|
MLH1 negative
|
neuroendocrine tumor
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) locally advanced or metastatic well-differentiated, Grade 3 neuroendocrine tumors or unresectable or metastatic extrapulmonary poorly differentiated neuroendocrine carcinoma, large or small cell carcinoma, or mixed neuroendocrine/non-neuroendocrine neoplasms who have progressed on or following prior treatment (NCCN.org).
|
detail...
|
CD274 positive
|
lung large cell carcinoma
|
sensitive
|
Cisplatin + Ipilimumab + Nivolumab + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Platinol (cisplatin), Alimta (pemetrexed), Opdivo (nivolumab), and Yervoy (ipilimumab) is in guidelines as first-line therapy for patients with advanced or metastatic large cell lung cancer with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
FLT3 exon19
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Idarubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Idamycin (idarubicin) and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
PMS2 negative
|
ovary epithelial cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
cervical cancer
|
sensitive
|
Bevacizumab + Paclitaxel + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) combined with Taxol (paclitaxel) and Avastin (bevacizumab) is included in guidelines as first-line therapy for patients with CD274 (PD-L1)-positive cervical cancer (NCCN.org).
|
detail...
|
NRAS exon2
|
colon cancer
|
resistant
|
Cetuximab
|
Guideline |
Actionable |
Erbitux (cetuximab) is not indicated for use in colon cancer patients with NRAS exon 2 mutations (NCCN.org).
|
detail...
|
RET V804M RET S904C
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Compound germline RET V804M and S904C mutations result in multiple endocrine neoplasia, type 2B (MEN 2B), which is associated with high risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
MSH2 negative
|
stomach cancer
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon20
|
acute myeloid leukemia
|
sensitive
|
Gilteritinib
|
Guideline |
Actionable |
Xospata (gilteritinib) is included in guidelines for patients with relapsed or refractory acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MSH6 negative
|
stomach cancer
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
vaginal carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as preferred second-line or subsequent therapy for patients with recurrent or metastatic vaginal squamous cell carcinoma or adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FGFR2 rearrange
|
cholangiocarcinoma
|
sensitive
|
Futibatinib
|
Guideline |
Actionable |
Lytgobi (futibatinib) is included in guidelines as subsequent-line therapy (category 2A) for patients with cholangiocarcinoma harboring an FGFR2 fusion or rearrangement (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus adenocarcinoma
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF V600X
|
skin melanoma
|
sensitive
|
Cobimetinib + Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) and Cotellic (cobimetinib) combination therapy is included in guidelines as a second-line or subsequent therapy for patients with metastatic or unresectable cutaneous melanoma harboring a BRAF V600 activating mutation (NCCN.org).
|
detail...
|
MSH6 mutant
|
ovarian cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in MSH6 result in Lynch syndrome, which is associated with increased risk of ovarian cancer (NCCN.org).
|
detail...
|
BRAF V600E
|
ovary epithelial cancer
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) and Mekinist (trametinib) combination therapy is included in guidelines as systemic therapy for patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer harboring BRAF V600E (NCCN.org).
|
detail...
|
CD274 positive
|
esophagus adenocarcinoma
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with first-line chemotherapy including Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as preferred first-line therapy for patients with locally advanced, recurrent, or metastatic ERBB2 (HER2) overexpression negative esophageal adenocarcinoma expressing PD-L1 (CD274) with CPS >/= 5 (category 1) or with CPS < 5 (category 2B) (NCCN.org).
|
detail...
|
MSH6 negative
|
Adenocarcinoma of Unknown Primary
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines for patients with adenocarcinoma of unknown primary with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
TP53 mutant
|
mantle cell lymphoma
|
not applicable
|
N/A
|
Guideline |
Prognostic |
TP53 mutations are associated with poor prognosis in patients with mantle cell lymphoma who are treated with conventional therapy, including transplant (NCCN.org).
|
detail...
|
MSH6 negative
|
intrahepatic cholangiocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy (category 2B) for patients with biliary tract cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including intrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
CD274 positive
|
triple-receptor negative breast cancer
|
sensitive
|
Nab-paclitaxel + Pembrolizumab
|
Guideline |
Actionable |
Combination of Keytruda (pembrolizumab) and Abraxane (nab-paclitaxel) is included in guidelines for patients with recurrent or metastatic CD274 (PD-L1)-positive (CPS >or= 10) triple-receptor negative breast cancer (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) is indicated in the guidelines as second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
MLH1 negative
|
esophagus adenocarcinoma
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF V600E
|
intrahepatic cholangiocarcinoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) in combination with Mekinist (trametinib) is included in guidelines as subsequent-line therapy for patients with biliary cancer harboring BRAF V600E, including intrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
BRAF V600E
|
lung non-small cell carcinoma
|
sensitive
|
Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) is included in guidelines as a first-line therapy for advanced or metastatic non-small cell lung cancer patients harboring BRAF V600E mutations who can not tolerate the combination of Mekinist (trametinib) and Tafinlar (dabrafenib) (NCCN.org).
|
detail...
|
FLT3 exon16
|
acute myeloid leukemia
|
sensitive
|
Gilteritinib
|
Guideline |
Actionable |
Xospata (gilteritinib) is included in guidelines for patients with relapsed or refractory acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
ALK rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Erlotinib
|
Guideline |
Actionable |
EGFR tyrosine kinase inhibitors including Tarceva (erlotinib), Iressa (gefitinib), Gilotrif (afatinib), and Tagrisso (osimertinib) are not indicated for use as subsequent therapy in ALK rearranged non-small cell lung cancer patients who relapsed on Alecensa (alectinib), Xalkori (crizotinib), or Zykadia (ceritinib) (NCCN.org).
|
detail...
|
PMS2 negative
|
chondrosarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic chondrosarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
lung large cell carcinoma
|
sensitive
|
Carboplatin + Cemiplimab + Paclitaxel
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Taxol (paclitaxel), and Libtayo (cemiplimab) is in guidelines as first-line therapy for patients with advanced or metastatic large cell lung cancer with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
FLT3 exon 14 ins
|
acute myeloid leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
FLT3 internal tandem duplication (FLT3-ITD) mutations are associated with inferior prognosis in acute myeloid leukemia patients with normal karyotype (NCCN.org).
|
detail...
|
PMS2 negative
|
osteosarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic osteosarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
rectum cancer
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as a primary therapy for advanced or metastatic rectum cancer patients with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
DNMT3A mutant
|
angioimmunoblastic T-cell lymphoma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
DNMT3A mutations aid in the diagnosis of angioimmunoblastic T-cell lymphoma (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Idelalisib + Rituximab
|
Guideline |
Actionable |
Zydelig (idelalisib) combined with Rituxan (rituximab) is indicated in the guidelines as second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with a TP53 mutation (NCCN.org).
|
detail...
|
FLT3 exon17
|
acute myeloid leukemia
|
sensitive
|
Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MSH2 negative
|
esophagus adenocarcinoma
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 mutant
|
rectum cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Lynch syndrome results from germline mutations in DNA mismatch repair genes including MLH1, MSH2, MSH6, and PMS2, and is associated with increased risk of developing colorectal cancer (NCCN.org).
|
detail...
|
MSH6 negative
|
pancreatic adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line or subsequent therapy for patients with locally advanced, metastatic, or recurrent pancreatic adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 mutant
|
ovarian cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in MLH1 result in Lynch syndrome, which is associated with increased risk of ovarian cancer (NCCN.org).
|
detail...
|
NRAS exon4
|
rectum cancer
|
resistant
|
Cetuximab
|
Guideline |
Actionable |
Erbitux (cetuximab) is not indicated for use in rectum cancer patients with NRAS exon 4 mutations (NCCN.org).
|
detail...
|
MSH6 mutant
|
endometrial carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in MSH6 result in Lynch syndrome, which is associated with increased risk of developing endometrial carcinoma (NCCN.org).
|
detail...
|
PMS2 negative
|
endometrial carcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line or second-line therapy for patients with high microsatellite instability (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) recurrent endometrial carcinoma (NCCN.org).
|
detail...
|
MLH1 negative
|
stomach cancer
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
rectum cancer
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as a primary therapy for advanced or metastatic rectum cancer patients with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
lung large cell carcinoma
|
sensitive
|
Carboplatin + Pembrolizumab + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Alimta (pemetrexed), and Keytruda (pembrolizumab) is in guidelines as preferred first-line therapy for patients with advanced or metastatic non-small cell lung cancer, not otherwise specified, with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Combination Opdivo (nivolumab) plus Yervoy (ipilimumab) is in guidelines as first-line or continuation maintenance therapy for advanced or metastatic non-small cell lung cancer patients with CD274 (PD-L1) expression >1% and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MLH1 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon18
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin), in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine), is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Obinutuzumab
|
Guideline |
Actionable |
Gazyva (obinutuzumab) is indicated in the guidelines as first line therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
FLT3 exon22
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Idarubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Idarubicin and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
ROS1 rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Gefitinib
|
Guideline |
Actionable |
EGFR tyrosine kinase inhibitors including Tarceva (erlotinib), Iressa (gefitinib), Gilotrif (afatinib), and Tagrisso (osimertinib) are not indicated for use as subsequent therapy in ROS1 rearranged non-small cell lung cancer patients who relapsed on Alecensa (alectinib), Xalkori (crizotinib), or Zykadia (ceritinib) (NCCN.org).
|
detail...
|
IDH1 mutant
|
malignant astrocytoma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
IDH1 mutations aid in the diagnosis of grade II and grade III astrocytomas (NCCN.org).
|
detail...
|
NRAS mutant
|
skin melanoma
|
sensitive
|
Binimetinib
|
Guideline |
Actionable |
Mektovi (binimetinib) is included in guidelines as second-line therapy for patients with metastatic or unresectable cutaneous melanoma harboring an NRAS mutation (NCCN.org).
|
detail...
|
PMS2 negative
|
small intestine adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as a subsequent therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
rectum cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as a primary therapy for advanced or metastatic rectum cancer patients with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Carboplatin + Durvalumab + Nab-paclitaxel + Tremelimumab
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Abraxane (nab-paclitaxel), Imfinzi (durvalumab), and Imjudo (tremelimumab) is in guidelines as first-line therapy for patients with advanced or metastatic non-small cell lung cancer, not otherwise specified, with CD274 (PD-L1) expression >/=1% - 49% (category 1) or >/= 50% (category 2B), and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MLH1 negative
|
endometrial carcinoma
|
sensitive
|
Avelumab
|
Guideline |
Actionable |
Bavencio (avelumab) is included in guidelines as a second-line or subsequent-line therapy for patients with high microsatellite instability (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) recurrent endometrial carcinoma (NCCN.org).
|
detail...
|
PMS2 negative
|
intrahepatic cholangiocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as primary therapy and subsequent-line therapy for patients with unresectable or metastatic biliary tract cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including intrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
ROS1 rearrange
|
lung non-small cell carcinoma
|
sensitive
|
Ceritinib
|
Guideline |
Actionable |
Zykadia (ceritinib) is included in guidelines as first-line therapy for ROS1-rearranged non-small cell lung cancer, but is not indicated after patients become resistant to Xalkori (crizotinib) (NCCN.org).
|
detail...
|
MLH1 negative
|
rectum cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with advanced or metastatic rectal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
breast cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines for patients with metastatic or unresectable breast cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) who have progressed on or following prior treatment (NCCN.org).
|
detail...
|
MSH2 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
cervical cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as preferred second-line or subsequent therapy for patients with cervical cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
STK11 mutant
|
small intestine adenocarcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Peutz-Jeghers syndrome often results from mutations in the STK11 gene, and is associated with increased risk of developing small bowel adenocarcinoma (NCCN.org).
|
detail...
|
CD274 positive
|
esophagus squamous cell carcinoma
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with first-line chemotherapy including Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as preferred first-line therapy for patients with locally advanced, recurrent, or metastatic esophageal squamous cell carcinoma expressing PD-L1 (CD274) with CPS >/= 10 (category 1) and for patients with CPS <10 (category 2B) (NCCN.org).
|
detail...
|
BRAF V600X
|
skin melanoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) and Mekinist (trametinib) combination therapy is included in guidelines as neoadjuvant or adjuvant therapy for stage III disease and as second-line or subsequent therapy for patients with metastatic or unresectable cutaneous melanoma harboring a BRAF V600 mutation (NCCN.org).
|
detail...
|
PMS2 negative
|
vulva cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a second-line therapy for patients with MSI high or dMMR (often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) vulva cancer (NCCN.org).
|
detail...
|
PMS2 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Idelalisib + Rituximab
|
Guideline |
Actionable |
Zydelig (idelalisib) combined with Rituxan (rituximab) is indicated in the guidelines as second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
PMS2 negative
|
colon cancer
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as primary or subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
KIT act mut
|
skin melanoma
|
sensitive
|
Nilotinib
|
Guideline |
Actionable |
Tasigna (nilotinib) is included in guidelines as second-line therapy for metastatic or unresectable cutaneous melanoma patients with KIT activating mutations (NCCN.org).
|
detail...
|
PMS2 mutant
|
rectum cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Lynch syndrome results from germline mutations in DNA mismatch repair genes including MLH1, MSH2, MSH6, and PMS2, and is associated with increased risk of developing colorectal cancer (NCCN.org).
|
detail...
|
FLT3 exon17
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Idarubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Idamycin (idarubicin) and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
RET C611X
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline RET C611X mutations result in multiple endocrine neoplasia, type 2A (MEN 2A), which is associated with high risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
PMS2 negative
|
ampulla of Vater adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) and Yervoy (ipilimumab) combination therapy is included in guidelines as first-line or subsequent therapy for metastatic ampullary adenocarcinoma patients with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
JAK2 mutant
|
essential thrombocythemia
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
JAK2 mutations aid in the diagnosis of essential thrombocythemia (NCCN.org).
|
detail...
|
POLE inact mut
|
colorectal carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline POLE inactivating mutations result in polymerase proofreading-associated polyposis and are associated with increased risk of developing colorectal carcinoma (NCCN.org).
|
detail...
|
MLH1 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH1 wild-type
|
IDH-wildtype glioblastoma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
Wild-type IDH1 aids in the diagnosis of glioblastoma (NCCN.org).
|
detail...
|
FGFR2 fusion
|
cholangiocarcinoma
|
sensitive
|
Futibatinib
|
Guideline |
Actionable |
Lytgobi (futibatinib) is included in guidelines as subsequent-line therapy (category 2A) for patients with cholangiocarcinoma harboring an FGFR2 fusion or rearrangement (NCCN.org).
|
detail...
|
BRAF V600E
|
glioblastoma
|
sensitive
|
Cobimetinib + Vemurafenib
|
Guideline |
Actionable |
Combination of Zelboraf (vemurafenib) and Cotellic (cobimetinib) is included in guidelines for patients with recurrent glioblastoma harboring BRAF V600E (NCCN.org).
|
detail...
|
IDH2 mutant
|
polycythemia vera
|
not applicable
|
N/A
|
Guideline |
Prognostic |
IDH2 mutations are associated with inferior overall survival and leukemia-free survival in patients with polycythemia vera (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Cisplatin + Ipilimumab + Nivolumab + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Platinol (cisplatin), Alimta (pemetrexed), Opdivo (nivolumab), and Yervoy (ipilimumab) is in guidelines as first-line therapy for patients with advanced or metastatic non-small cell lung cancer, not otherwise specified, with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
PMS2 negative
|
gallbladder cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as primary therapy and subsequent-line therapy for patients with unresectable or metastatic biliary tract cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including gallbladder cancer (NCCN.org).
|
detail...
|
BRAF V600E
|
hairy cell leukemia
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
BRAF V600E is diagnostic and aids in distinguishing classic hairy cell leukemia (cHCL) from variant hairy cell leukemia (HCLv) and other B-cell lymphomas and leukemias (PMID: 29118233, NCCN.org).
|
detail...
29118233
|
BRAF V600E
|
skin melanoma
|
sensitive
|
Cobimetinib + Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) and Cotellic (cobimetinib) combination therapy is included in cutaneous melanoma guidelines for patients with metastatic or unresectable disease harboring a BRAF V600 activating mutation (NCCN.org).
|
detail...
|
MSH2 negative
|
small intestine adenocarcinoma
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF V600E/K
|
skin melanoma
|
sensitive
|
Binimetinib + Encorafenib
|
Guideline |
Actionable |
Braftovi (encorafenib) in combination with Mektovi (binimetinib) is included in guidelines as first-line and second-line therapy for patients with metastatic or unresectable cutaneous melanoma harboring BRAF V600E or V600K mutations (PMID: 30959471; NCCN.org).
|
30959471
detail...
|
BRAF V600K
|
skin melanoma
|
sensitive
|
Dabrafenib + Pembrolizumab + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) plus Mekinist (trametinib) in combination with an immune checkpoint inhibitor, such as Keytruda (pembrolizumab), is included in guidelines as second-line or subsequent therapy (category 2A) for patients with metastatic or unresectable cutaneous melanoma harboring a BRAF V600 mutation, such as BRAF V600K (NCCN.org).
|
detail...
|
RET fusion
|
papillary thyroid carcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines for patients with papillary thyroid carcinoma harboring RET fusions (NCCN.org).
|
detail...
|
FLT3 exon14
|
acute myeloid leukemia
|
sensitive
|
Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MLH1 negative
|
oncocytic carcinoma of the thyroid
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with Hurthle cell thyroid carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) after progression on prior treatment (NCCN.org).
|
detail...
|
MSH2 negative
|
cervical cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as preferred second-line or subsequent therapy for patients with cervical cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
Ewing sarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic Ewing sarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon 14 ins
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Idarubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Idamycin (idarubicin) and Cytosar-U (cytarabine) is included in guidelines (category 1) for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Acalabrutinib + Obinutuzumab
|
Guideline |
Actionable |
Calquence (acalabrutinib) combined with Gazyva (obinutuzumab) is indicated in the guidelines as first-line therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with a TP53 mutation (NCCN.org).
|
detail...
|
BRAF V600E
|
rectum cancer
|
resistant
|
Panitumumab
|
Guideline |
Actionable |
Vectibix (panitumumab), as a monotherapy, is not indicated for use in rectum cancer patients with BRAF V600E (NCCN.org).
|
detail...
|
BRAF V600E
|
Squamous Cell Carcinoma of Unknown Primary
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
The combination of Tafinlar (dabrafenib) and Mekinist (trametinib) is included in guidelines for patients with squamous cell carcinoma of unknown primary harboring BRAF V600E (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Acalabrutinib
|
Guideline |
Actionable |
Calquence (acalabrutinib) is indicated in the guidelines as second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
ALK rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Atezolizumab
|
Guideline |
Actionable |
Immune checkpoint inhibitors including Opdivo (nivolumab), Keytruda (pembrolizumab), Tecentriq (atezolizumab), and Imfinzi (durvalumab) are not indicated for use as subsequent therapy in non-small cell lung cancer patients with ALK rearrangement (NCCN.org).
|
detail...
|
BRAF V600E
|
pilocytic astrocytoma
|
sensitive
|
Selumetinib
|
Guideline |
Actionable |
Koselugo (selumetinib) is included in guidelines for patients with recurrent or progressive pilocytic astrocytoma harboring BRAF V600E (NCCN.org).
|
detail...
|
ROS1 rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Osimertinib
|
Guideline |
Actionable |
EGFR tyrosine kinase inhibitors including Tarceva (erlotinib), Iressa (gefitinib), Gilotrif (afatinib), and Tagrisso (osimertinib) are not indicated for use as subsequent therapy in ROS1 rearranged non-small cell lung cancer patients who relapsed on Alecensa (alectinib), Xalkori (crizotinib), or Zykadia (ceritinib) (NCCN.org).
|
detail...
|
ALK rearrange
|
lung non-small cell carcinoma
|
sensitive
|
Ceritinib
|
Guideline |
Actionable |
Zykadia (ceritinib) is included in guidelines as first-line and as subsequent therapy for patients with advanced or metastatic ALK-rearranged non-small cell lung cancer (NCCN.org).
|
detail...
|
PMS2 negative
|
stomach cancer
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
esophagus squamous cell carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a preferred second-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal squamous cell carcinoma with CD274 (PD-L1) expression (CPS >/=10) (NCCN.org).
|
detail...
|
MSH2 mutant
|
small intestine adenocarcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Lynch syndrome results from germline mutations in DNA mismatch repair genes including MLH1, MSH2, MSH6, and PMS2, and is associated with increased risk of developing small bowel adenocarcinoma (NCCN.org).
|
detail...
|
MLH1 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
small intestine adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as a subsequent therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
ROS1 rearrange
|
lung non-small cell carcinoma
|
sensitive
|
Entrectinib
|
Guideline |
Actionable |
Rozlytrek (entrectinib) is included in guidelines as a first-line or subsequent therapy for patients with advanced or metastatic ROS1 rearrangement-positive non-small cell lung cancer (NCCN.org).
|
detail...
|
TP53 mutant
|
nephroblastoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in TP53 result in Li-Fraumeni syndrome, which is associated with increased risk of developing Wilms tumor (nephroblastoma) (NCCN.org).
|
detail...
|
FLT3 exon14
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Idarubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Idamycin (idarubicin) and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
POLD1 inact mut
|
rectum cancer
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as systemic therapy for patients with advanced or metastatic rectal cancer harboring POLD1 inactivating mutations (NCCN.org).
|
detail...
|
BRAF V600X
|
skin melanoma
|
sensitive
|
Atezolizumab + Cobimetinib + Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) plus Cotellic (cobimetinib) in combination with an immune checkpoint inhibitor, such as Tecentriq (atezolizumab), is included in guidelines as second-line or subsequent therapy (category 2A) for patients with metastatic or unresectable cutaneous melanoma harboring a BRAF V600 mutation (NCCN.org).
|
detail...
|
JAK1 rearrange
|
childhood B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
JAK1 rearrangements are associated with a poor prognosis in pediatric patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
BRAF V600E
|
ganglioglioma
|
sensitive
|
Cobimetinib + Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) and Cotellic (cobimetinib) combination therapy is included in guidelines as an adjuvant treatment for patients with ganglioglioma harboring BRAF V600E (NCCN.org).
|
detail...
|
MLH1 inact mut
|
prostate cancer
|
sensitive
|
Enzalutamide + Talazoparib
|
Guideline |
Actionable |
Talzenna (talazoparib) plus Xtandi (enzalutamide) is included in guidelines as systemic therapy for patients with metastatic castration-resistant prostate cancer harboring a pathogenic germline or somatic MLH1 mutation who have not been treated in the setting of castration-resistant prostate cancer (NCCN.org).
|
detail...
|
MSH2 mutant
|
ovarian cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in MSH2 result in Lynch syndrome, which is associated with increased risk of ovarian cancer (NCCN.org).
|
detail...
|
ABL1 rearrange
|
myeloid neoplasm
|
sensitive
|
Imatinib
|
Guideline |
Actionable |
Gleevec (imatinib) is included in guidelines for patients with a myeloid/lymphoid neoplasm with eosinophilia harboring a ABL1 rearrangement (NCCN.org).
|
detail...
|
BRAF V600E
|
extrahepatic bile duct carcinoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) in combination with Mekinist (trametinib) is included in guidelines as subsequent-line therapy for patients with biliary cancer harboring BRAF V600E, including extrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
PIK3CA mutant
|
Erdheim-Chester disease
|
sensitive
|
Sirolimus
|
Guideline |
Actionable |
Rapamune (sirolimus) is included in guidelines as first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring PIK3CA mutations (NCCN.org).
|
detail...
|
RET fusion
|
vaginal carcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as second-line or subsequent therapy for patients with recurrent or metastatic vaginal squamous cell carcinoma or adenocarcinoma harboring an RET fusion (NCCN.org).
|
detail...
|
MSH2 negative
|
intrahepatic cholangiocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as primary therapy and subsequent-line therapy for patients with unresectable or metastatic biliary tract cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including intrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
JAK1 mutant
|
childhood B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
JAK1 mutations are associated with a poor prognosis in pediatric patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
BRAF V600K
|
skin melanoma
|
sensitive
|
Binimetinib + Encorafenib
|
Guideline |
Actionable |
Braftovi (encorafenib) in combination with Mektovi (binimetinib) is included in guidelines as first-line and second-line therapy for patients with metastatic or unresectable cutaneous melanoma harboring BRAF V600E or V600K mutations (PMID: 30959471; NCCN.org).
|
30959471
detail...
|
KIT D816V
|
systemic mastocytosis
|
not applicable
|
N/A
|
Guideline |
Prognostic |
KIT D816V is associated with an adverse prognosis in patients with systemic mastocytosis (NCCN.org).
|
detail...
|
MSH6 negative
|
osteosarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic osteosarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
hepatocellular carcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) hepatocellular carcinoma (NCCN.org).
|
detail...
|
ATM mutant
|
prostate cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline ATM mutations are associated with increased risk of developing prostate cancer (NCCN.org).
|
detail...
|
CD274 positive
|
lung large cell carcinoma
|
sensitive
|
Carboplatin + Ipilimumab + Nivolumab + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Alimta (pemetrexed), Opdivo (nivolumab), and Yervoy (ipilimumab) is in guidelines as first-line therapy for patients with advanced or metastatic large cell lung cancer with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Atezolizumab + Bevacizumab + Carboplatin + Paclitaxel
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Taxol (paclitaxel), Avastin (bevacizumab), and Tecentriq (atezolizumab) is in guidelines as first-line therapy for patients with advanced or metastatic lung adenocarcinoma with CD274 (PD-L1) expression of greater than or equal to 1% and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
IDH2 mutant
|
high grade glioma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
IDH2 mutations aid in the diagnosis of gliomas (NCCN.org).
|
detail...
|
MSH6 negative
|
rectum cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with advanced or metastatic rectal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF V600E
|
skin melanoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) and Mekinist (trametinib) combination therapy is included in guidelines for cutaneous melanoma patients harboring a BRAF V600 mutation, such as BRAF V600E, as neoadjuvant or adjuvant therapy for stage III disease and as systemic therapy for patients with unresectable or metastatic disease (NCCN.org).
|
detail...
|
RET E768X
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline RET E768X mutations result in multiple endocrine neoplasia, type 2A (MEN 2A), which is associated with increased risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Carboplatin + Ipilimumab + Nivolumab + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Alimta (pemetrexed), Opdivo (nivolumab), and Yervoy (ipilimumab) is in guidelines as first-line therapy for patients with advanced or metastatic lung adenocarcinoma with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
CD274 positive
|
triple-receptor negative breast cancer
|
sensitive
|
Carboplatin + Gemcitabine + Pembrolizumab
|
Guideline |
Actionable |
Combination of Keytruda (pembrolizumab), Paraplatin (carboplatin), and Gemzar (gemcitabine) is included in guidelines for patients with recurrent or metastatic CD274 (PD-L1)-positive (CPS >or= 10) triple-receptor negative breast cancer (NCCN.org).
|
detail...
|
TP53 mutant
|
B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
TP53 mutations are associated with poor prognosis in patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
MSH6 negative
|
small intestine adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon19
|
acute myeloid leukemia
|
sensitive
|
Gilteritinib
|
Guideline |
Actionable |
Xospata (gilteritinib) is included in guidelines for patients with relapsed or refractory acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Ibrutinib + Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) combined with Imbruvica (ibrutinib) is indicated in guidelines as first-line (category 2A), second-line, or third-line therapy (category 2B) for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
BRAF V600E
|
gallbladder cancer
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) in combination with Mekinist (trametinib) is included in guidelines as subsequent-line therapy for patients with biliary cancer harboring BRAF V600E, including gallbladder cancer (NCCN.org).
|
detail...
|
BRAF V600E
|
anaplastic astrocytoma
|
sensitive
|
Cobimetinib + Vemurafenib
|
Guideline |
Actionable |
Combination of Zelboraf (vemurafenib) and Cotellic (cobimetinib) is included in guidelines for patients with recurrent anaplastic gliomas harboring BRAF V600E, including anaplastic astrocytoma (NCCN.org).
|
detail...
|
BRAF V600E
|
pancreatic adenocarcinoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) and Mekinist (trametinib) combination therapy is included in guidelines as first-line therapy for patients with locally advanced (category 2A) or metastatic (category 2B) pancreatic adenocarcinoma harboring BRAF V600E, and as subsequent-line therapy for patients with locally advanced, recurrent, or metastatic disease (category 2A) (NCCN.org).
|
detail...
|
CD274 positive
|
vaginal carcinoma
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as second-line or subsequent therapy for patients with recurrent or metastatic vaginal squamous cell carcinoma or adenocarcinoma with CD274 (PD-L1) expression (CPS >/= 1) (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Methylprednisolone + Rituximab
|
Guideline |
Actionable |
Artisone-Wyeth (methylprednisolone) combined with Rituxan (rituximab) is indicated in the guidelines as first-line therapy and second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with a TP53 mutation (NCCN.org).
|
detail...
|
RET mutant
|
medullary thyroid carcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines for patients with medullary thyroid carcinoma harboring RET mutations (NCCN.org).
|
detail...
|
MLH1 mutant
|
stomach cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in MLH1 result in Lynch syndrome, which is associated with increased risk of early onset of gastric cancer (NCCN.org).
|
detail...
|
PMS2 mutant
|
colon cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Lynch syndrome results from germline mutations in DNA mismatch repair genes including MLH1, MSH2, MSH6, and PMS2, and is associated with increased risk of developing colon cancer (NCCN.org).
|
detail...
|
MLH1 negative
|
stomach cancer
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
vaginal carcinoma
|
sensitive
|
Cisplatin + Paclitaxel + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with Platinol (cisplatin) and Taxol (paclitaxel) is included in guidelines as preferred first-line therapy for patients with recurrent or metastatic vaginal squamous cell carcinoma or adenocarcinoma with CD274 (PD-L1) expression (CPS >/= 1) (NCCN.org).
|
detail...
|
APC mutant
|
small intestine adenocarcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Familial adenomatous polyposis results from germline mutations in the APC gene, and is associated with increased risk of developing small bowel adenocarcinoma (NCCN.org).
|
detail...
|
MSH2 negative
|
gallbladder cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy (category 2B) for patients with biliary tract cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including gallbladder cancer (NCCN.org).
|
detail...
|
RET V804X
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline RET V804X mutations result in multiple endocrine neoplasia, type 2A (MEN 2A), which is associated with increased risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
MLH1 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line, second-line, or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) esophageal squamous cell carcinoma that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
CD274 positive
|
cervical cancer
|
sensitive
|
Cisplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) combined with Platinol (cisplatin) is included in guidelines as first-line therapy for patients with CD274 (PD-L1)-positive cervical cancer (NCCN.org).
|
detail...
|
RET Y791X
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline RET Y791X mutations result in multiple endocrine neoplasia, type 2A (MEN 2A), which is associated with increased risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
ALK fusion
|
Erdheim-Chester disease
|
sensitive
|
Brigatinib
|
Guideline |
Actionable |
Alunbrig (brigatinib) is included in guidelines as first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring ALK fusions (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Methylprednisolone + Obinutuzumab
|
Guideline |
Actionable |
Artisone-Wyeth (methylprednisolone) combined with Gazyva (obinutuzumab) is indicated in guidelines as first-line therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss and for patients with relapsed or refractory disease after prior BTK inhibitor or Venclexta (venetoclax)-based therapy (NCCN.org).
|
detail...
|
ABL1 rearrange
|
B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
ABL1 rearrangements are associated with a poor prognosis in patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
MSH2 negative
|
vulva cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a second-line therapy for patients with MSI high or dMMR (often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) vulva cancer (NCCN.org).
|
detail...
|
MLH1 mutant
|
pancreatic cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in MLH1 result in Lynch syndrome, which is associated with increased risk of developing pancreatic cancer (NCCN.org).
|
detail...
|
BRAF V600E
|
stomach cancer
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) and Mekinist (trametinib) combination therapy is included in guidelines as second-line or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer harboring BRAF V600E (NCCN.org).
|
detail...
|
CD274 positive
|
lung squamous cell carcinoma
|
sensitive
|
Cemiplimab + Cisplatin + Paclitaxel
|
Guideline |
Actionable |
Combination Platinol (cisplatin), Taxol (paclitaxel), and Libtayo (cemiplimab) is in guidelines as first-line therapy for patients with advanced or metastatic squamous cell lung cancer with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
APC mutant
|
medulloblastoma
|
not applicable
|
N/A
|
Guideline |
Prognostic |
WNT-driven medulloblastomas, characterized by CTNNB1 or APC mutations, are associated with favorable prognosis (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
intrahepatic cholangiocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy (category 2B) for patients with biliary tract cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including intrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
IDH1 act mut
|
astrocytoma, IDH-mutant, grade 3
|
sensitive
|
Vorasidenib
|
Guideline |
Actionable |
Voranigo (vorasidenib) is included in guidelines for patients with recurrent or progressive WHO grade 3 astrocytoma harboring an IDH1 activating mutation (NCCN.org).
|
detail...
|
ABL1 rearrange
|
myeloid neoplasm
|
sensitive
|
Dasatinib
|
Guideline |
Actionable |
Sprycel (dasatinib) is included in guidelines as a preferred regimen for patients with a myeloid/lymphoid neoplasm with eosinophilia harboring a ABL1 rearrangement (NCCN.org).
|
detail...
|
FLT3 exon23
|
acute myeloid leukemia
|
sensitive
|
Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
CD274 positive
|
esophagus adenocarcinoma
|
sensitive
|
Cisplatin + Fluorouracil + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with first-line chemotherapy including Adrucil (fluorouracil) and Platinol (cisplatin) is included in guidelines as preferred first-line therapy for patients with locally advanced, recurrent, or metastatic ERBB2 (HER2) overexpression-negative esophageal adenocarcinoma expressing PD-L1 (CD274) with CPS >/= 10 (category 1) or with CPS >/= 1 and <10 (category 2B) (NCCN.org).
|
detail...
|
IDH1 mutant
|
myelofibrosis
|
not applicable
|
N/A
|
Guideline |
Prognostic |
IDH1 mutations are associated with inferior leukemia-free survival in patients with myelofibrosis (NCCN.org).
|
detail...
|
CDKN2A mutant
|
pancreatic cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in CDKN2A results in familial malignant melanoma syndrome, which is associated with increased risk of developing pancreatic cancer (NCCN.org).
|
detail...
|
RET C620X
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline RET C620X mutations result in multiple endocrine neoplasia, type 2A (MEN 2A), which is associated with high risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
RET C618X
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline RET C618X mutations result in multiple endocrine neoplasia, type 2A (MEN 2A), which is associated with high risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
CD274 over exp
|
lung adenocarcinoma
|
sensitive
|
Cemiplimab
|
Guideline |
Actionable |
Libtayo (cemiplimab) is included in guidelines as preferred first-line therapy for patients with advanced or metastatic lung adenocarcinoma with CD274 (PD-L1) expression of at least 50% and negative for actionable molecular biomarkers; and as continued maintenance therapy (NCCN.org).
|
detail...
|
MSH6 negative
|
colon cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as primary or subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon 14 ins
|
acute myeloid leukemia
|
sensitive
|
Quizartinib
|
Guideline |
Actionable |
Vanflyta (quizartinib) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
RET rearrange
|
lung non-small cell carcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is in guidelines as a first-line and subsequent therapy for patients with advanced or metastatic non-small cell lung cancer harboring RET rearrangements (NCCN.org).
|
detail...
|
BRAF V600E
|
skin melanoma
|
sensitive
|
Dabrafenib + Pembrolizumab + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) plus Mekinist (trametinib) in combination with an immune checkpoint inhibitor, such as Keytruda (pembrolizumab), is included in guidelines as second-line or subsequent therapy (category 2A) for patients with metastatic or unresectable cutaneous melanoma harboring a BRAF V600 mutation, such as BRAF V600E (NCCN.org).
|
detail...
|
BRAF V600E
|
anaplastic astrocytoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Combination of Mekinist (trametinib) and Tafinlar (dabrafenib) is included in guidelines for patients with recurrent anaplastic gliomas harboring BRAF V600E, including anaplastic astrocytoma (NCCN.org).
|
detail...
|
RET fusion
|
salivary gland cancer
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines for patients with recurrent, unresectable, or metastatic salivary gland tumors harboring RET fusions (NCCN.org).
|
detail...
|
BRAF V600E
|
rectum cancer
|
sensitive
|
Cetuximab + Encorafenib
|
Guideline |
Actionable |
Braftovi (encorafenib) in combination with Erbitux (cetuximab) is included in guidelines as primary or subsequent therapy for patients with rectal cancer harboring BRAF V600E (NCCN.org).
|
detail...
|
FLT3 exon 14 ins
|
acute myeloid leukemia
|
sensitive
|
Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
MSH6 negative
|
ampulla of Vater adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for metastatic ampullary adenocarcinoma patients with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH1 wild-type
|
high grade glioma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
IDH1 wild-type is associated with increased risk of aggressive disease in patients with grade II or III infiltrative gliomas (NCCN.org).
|
detail...
|
MSH6 mutant
|
rectum cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Lynch syndrome results from germline mutations in DNA mismatch repair genes including MLH1, MSH2, MSH6, and PMS2, and is associated with increased risk of developing colorectal cancer (NCCN.org).
|
detail...
|
MLH1 negative
|
bone cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a systemic therapy for patients with unresectable or metastatic bone cancer with high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH1 act mut
|
malignant astrocytoma
|
sensitive
|
Ivosidenib
|
Guideline |
Actionable |
Tibsovo (ivosidenib) is included in guidelines for patients with astrocytoma harboring an IDH1 activating mutation (NCCN.org).
|
detail...
|
CD274 positive
|
vaginal carcinoma
|
sensitive
|
Carboplatin + Paclitaxel + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with Paraplatin (carboplatin) and Taxol (paclitaxel) is included in guidelines as preferred first-line therapy for patients with recurrent or metastatic vaginal squamous cell carcinoma or adenocarcinoma with CD274 (PD-L1) expression (CPS >/= 1) (NCCN.org).
|
detail...
|
MSH6 negative
|
ovary epithelial cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as systemic therapy for patients with recurrent or advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
testicular germ cell cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a third-line therapy for metastatic testicular germ cell cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
chordoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic chordoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon15
|
acute myeloid leukemia
|
sensitive
|
Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Cisplatin + Durvalumab + Pemetrexed Disodium + Tremelimumab
|
Guideline |
Actionable |
Combination Platinol (cisplatin), Alimta (pemetrexed disodium), Imfinzi (durvalumab), and Imjudo (tremelimumab) is in guidelines as first-line therapy for patients with advanced or metastatic non-small cell lung cancer, not otherwise specified, with CD274 (PD-L1) expression >/=1% - 49% (category 1) or >/= 50% (category 2B), and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
BRAF V600E
|
colon cancer
|
resistant
|
Cetuximab
|
Guideline |
Actionable |
Erbitux (cetuximab), as a monotherapy, is not indicated for use in colon cancer patients with BRAF V600E (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
not applicable
|
N/A
|
Guideline |
Prognostic |
TP53 mutations are associated with a poor prognosis in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (NCCN.org).
|
detail...
|
MSH6 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
NRAS exon4
|
rectum cancer
|
resistant
|
Panitumumab
|
Guideline |
Actionable |
Vectibix (panitumumab) is not indicated for use in rectum cancer patients with NRAS exon 4 mutations (NCCN.org).
|
detail...
|
IDH2 mutant
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) in combination with Cytosar-U (cytarabine) is included in guidelines for adult patients with acute myeloid leukemia harboring an IDH2 mutation (NCCN.org).
|
detail...
|
ALK rearrange ALK G1202R
|
lung non-small cell carcinoma
|
sensitive
|
Lorlatinib
|
Guideline |
Actionable |
Lorbrena (lorlatinib) is included in guidelines as subsequent therapy for patients with advanced or metastatic ALK-rearranged non-small cell lung cancer harboring ALK G1202R (NCCN.org).
|
detail...
|
MSH6 negative
|
endometrial carcinoma
|
sensitive
|
Avelumab
|
Guideline |
Actionable |
Bavencio (avelumab) is included in guidelines as a second-line or subsequent-line therapy for patients with high microsatellite instability (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) recurrent endometrial carcinoma (NCCN.org).
|
detail...
|
RET C634X
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline RET C634X mutations result in multiple endocrine neoplasia, type 2A (MEN 2A), which is associated with high risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
VHL inact mut
|
renal cell carcinoma
|
sensitive
|
Pazopanib
|
Guideline |
Actionable |
Votrient (pazopanib) is included in guidelines as systemic therapy for patients with renal cell carcinoma associated with Von Hippel-Lindau disease (NCCN.org).
|
detail...
|
ATM inact mut
|
prostate cancer
|
sensitive
|
Olaparib
|
Guideline |
Actionable |
Lynparza (olaparib) is included in guidelines as second-line therapy post androgen receptor-directed therapy for patients with metastatic castration-resistant prostate cancer harboring pathogenic mutations in ATM (NCCN.org).
|
detail...
|
ALK rearrange
|
lung non-small cell carcinoma
|
sensitive
|
Lorlatinib
|
Guideline |
Actionable |
Lorbrena (lorlatinib) is included in guidelines as preferred first-line therapy and as subsequent therapy for patients with advanced or metastatic ALK-rearranged non-small cell lung cancer (NCCN.org).
|
detail...
|
CD274 positive
|
esophagus squamous cell carcinoma
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with first-line chemotherapy including Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as preferred first-line therapy for patients with locally advanced, recurrent, or metastatic esophageal squamous cell carcinoma expressing PD-L1 (CD274) with CPS >/= 10 (category 1) and for patients with CPS <10 (category 2B) (NCCN.org).
|
detail...
|
NRAS exon4
|
colon cancer
|
resistant
|
Cetuximab
|
Guideline |
Actionable |
Erbitux (cetuximab) is not indicated for use in colon cancer patients with NRAS exon 4 mutations (NCCN.org).
|
detail...
|
RET fusion
|
esophagus adenocarcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as second-line or subsequent therapy for patients with locally advanced, recurrent, or metastatic esophageal adenocarcinoma harboring RET fusions (NCCN.org).
|
detail...
|
MLH1 negative
|
Adenocarcinoma of Unknown Primary
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with adenocarcinoma of unknown primary with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
bladder urothelial carcinoma
|
sensitive
|
Atezolizumab
|
Guideline |
Actionable |
Tecentriq (atezolizumab) is included in guidelines as a first-line therapy (category 2B) for cisplatin-ineligible bladder urothelial carcinoma patients with immune cell CD274 (PD-L1) expression greater than or equal to 5% (NCCN.org).
|
detail...
|
FLT3 exon17
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Cytosar-U (cytarabine) is included in guidelines as consolidation therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
BRAF V600K
|
skin melanoma
|
sensitive
|
Cobimetinib + Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) and Cotellic (cobimetinib) combination therapy is included in cutaneous melanoma guidelines for patients with metastatic or unresectable disease harboring a BRAF V600 activating mutation (NCCN.org).
|
detail...
|
FLT3 exon23
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin), in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine), is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
ROS1 rearrange
|
lung non-small cell carcinoma
|
sensitive
|
Repotrectinib
|
Guideline |
Actionable |
Augtyro (repotrectinib) is included in guidelines as first-line or subsequent therapy for patients with advanced or metastatic non-small cell lung cancer harboring a ROS1 rearrangement (NCCN.org).
|
detail...
|
FLT3 exon18
|
acute myeloid leukemia
|
sensitive
|
Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MSH2 negative
|
Adenocarcinoma of Unknown Primary
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with adenocarcinoma of unknown primary with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF V600E
|
ampulla of Vater adenocarcinoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) and Mekinist (trametinib) combination therapy is included in guidelines as first-line therapy with good (ECOG 0-1; category 3) or poor (category 2B) performance status, or as subsequent therapy, for metastatic ampullary adenocarcinoma patients harboring BRAF V600E (NCCN.org).
|
detail...
|
MSH2 negative
|
small intestine adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
gallbladder cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as primary therapy and subsequent-line therapy for patients with unresectable or metastatic biliary tract cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including gallbladder cancer (NCCN.org).
|
detail...
|
MSH2 negative
|
papillary thyroid carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with papillary thyroid carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) after progression on prior treatment (NCCN.org).
|
detail...
|
IDH2 mutant
|
myelofibrosis
|
not applicable
|
N/A
|
Guideline |
Prognostic |
IDH2 mutations are associated with inferior leukemia-free survival in patients with myelofibrosis (NCCN.org).
|
detail...
|
RET fusion
|
Erdheim-Chester disease
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring RET fusions (NCCN.org).
|
detail...
|
RET fusion
|
Adenocarcinoma of Unknown Primary
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines for patients with adenocarcinoma of unknown primary harboring RET fusions (NCCN.org).
|
detail...
|
PMS2 negative
|
rectum cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with advanced or metastatic rectal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF V600E
|
low grade glioma
|
sensitive
|
Cobimetinib + Vemurafenib
|
Guideline |
Actionable |
Combination of Zelboraf (vemurafenib) and Cotellic (cobimetinib) is included in guidelines for patients with recurrent or progressive low grade glioma harboring BRAF V600E (NCCN.org).
|
detail...
|
PMS2 negative
|
follicular thyroid carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with follicular thyroid carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) after progression on prior treatment (NCCN.org).
|
detail...
|
BRAF V600E
|
biliary tract cancer
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) in combination with Mekinist (trametinib) is included in guidelines as subsequent-line therapy for patients with biliary tract cancer harboring BRAF V600E (NCCN.org).
|
detail...
|
FGFR1 rearrange
|
myeloid and lymphoid neoplasms associated with FGFR1 abnormalities
|
sensitive
|
Ponatinib
|
Guideline |
Actionable |
Iclusig (ponatinib) is included in guidelines for patients with a myeloid/lymphoid neoplasm with eosinophilia harboring an FGFR1 rearrangement (NCCN.org).
|
detail...
|
BRAF V600E
|
Erdheim-Chester disease
|
sensitive
|
Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) is included in guidelines as preferred first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring BRAF V600E (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Carboplatin + Cemiplimab + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Alimta (pemetrexed disodium), and Libtayo (cemiplimab) is in guidelines as first-line therapy for patients with advanced or metastatic lung adenocarcinoma, with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
BRAF fusion
|
pilocytic astrocytoma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
BRAF fusions aid in the diagnosis of pilocytic astrocytoma (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
acute myeloid leukemia
|
sensitive
|
Sorafenib
|
Guideline |
Actionable |
Nexavar (sorafenib) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Carboplatin + Cemiplimab + Paclitaxel
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Taxol (paclitaxel), and Libtayo (cemiplimab) is in guidelines as first-line therapy for patients with advanced or metastatic lung adenocarcinoma with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MSH6 negative
|
papillary thyroid carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with papillary thyroid carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) after progression on prior treatment (NCCN.org).
|
detail...
|
MLH1 negative
|
colon cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as preferred primary or subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
ampulla of Vater adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) and Yervoy (ipilimumab) combination therapy is included in guidelines as first-line or subsequent therapy for metastatic ampullary adenocarcinoma patients with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Carboplatin + Pembrolizumab + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Alimta (pemetrexed), and Keytruda (pembrolizumab) is in guidelines as preferred first-line therapy for patients with advanced or metastatic non-small cell lung cancer, not otherwise specified, with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
IDH2 mutant
|
acute myeloid leukemia
|
sensitive
|
Enasidenib
|
Guideline |
Actionable |
Idhifa (enasidenib) is included in guidelines for patients with relapsed or refractory acute myeloid leukemia harboring an IDH2 mutation (NCCN.org).
|
detail...
|
PMS2 mutant
|
small intestine adenocarcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Lynch syndrome results from germline mutations in DNA mismatch repair genes including MLH1, MSH2, MSH6, and PMS2, and is associated with increased risk of developing small bowel adenocarcinoma (NCCN.org).
|
detail...
|
MSH2 negative
|
extrahepatic bile duct carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as primary therapy and subsequent-line therapy for patients with unresectable or metastatic biliary tract cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including extrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
RET M918X
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline RET M918X mutations result in multiple endocrine neoplasia, type 2B (MEN 2B), which is associated with high risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
JAK2 exon12
|
polycythemia vera
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
JAK2 exon 12 mutations aid in the diagnosis of polycythemia vera (NCCN.org).
|
detail...
|
MAP2K1 mutant
|
Erdheim-Chester disease
|
sensitive
|
Trametinib
|
Guideline |
Actionable |
Mekinist (trametinib) is included in guidelines as first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring mutations in the MAPK pathway such as ARAF, NRAS, KRAS, MAP2K1/2, PIK3CA, or with no detectable mutations, or for whom testing is not available (NCCN.org).
|
detail...
|
KIT act mut
|
skin melanoma
|
sensitive
|
Ripretinib
|
Guideline |
Actionable |
Qinlock (ripretinib) is included in guidelines as second-line therapy for metastatic or unresectable cutaneous melanoma patients with KIT activating mutations (NCCN.org).
|
detail...
|
BRAF V600E
|
small intestine adenocarcinoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) in combination with Mekinist (trametinib) is included in guidelines for patients with advanced or metastatic small bowel adenocarcinoma harboring BRAF V600E (NCCN.org).
|
detail...
|
PMS2 negative
|
extrahepatic bile duct carcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy (category 2B) for patients with biliary tract cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including extrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
MSH2 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
POLD1 inact mut
|
small intestine adenocarcinoma
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma harboring POLD1 inactivating mutations (NCCN.org).
|
detail...
|
CD274 positive
|
lung large cell carcinoma
|
sensitive
|
Carboplatin + Durvalumab + Nab-paclitaxel + Tremelimumab
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Abraxane (nab-paclitaxel), Imfinzi (durvalumab), and Imjudo (tremelimumab) is in guidelines as first-line therapy for patients with advanced or metastatic large cell lung cancer, with CD274 (PD-L1) expression >/=1% - 49% (category 1) or >/= 50% (category 2B), and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
BRAF V600E
|
skin melanoma
|
sensitive
|
Atezolizumab + Cobimetinib + Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) plus Cotellic (cobimetinib) in combination with an immune checkpoint inhibitor, such as Tecentriq (atezolizumab), is included in guidelines as second-line or subsequent therapy (category 2A) for patients with metastatic or unresectable cutaneous melanoma harboring a BRAF V600 mutation, such as BRAF V600E (NCCN.org).
|
detail...
|
MLH1 negative
|
esophagus adenocarcinoma
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon 14 ins
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Quizartinib
|
Guideline |
Actionable |
Vanflyta (quizartinib) in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
MSH6 negative
|
esophagus adenocarcinoma
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
pancreatic adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with locally advanced, metastatic, or recurrent pancreatic adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) who have not received prior immunotherapy (NCCN.org).
|
detail...
|
RET fusion
|
cholangiocarcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as primary (category 2B) or subsequent-line therapy (category 2A) for patients with unresectable or metastatic cholangiocarcinoma harboring RET fusions (NCCN.org).
|
detail...
|
ABL1 rearrange
|
childhood B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
ABL1 rearrangements are associated with a poor prognosis in pediatric patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
ALK rearrange
|
anaplastic large cell lymphoma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
ALK rearrangement aids in the diagnosis of anaplastic large cell lymphoma (NCCN.org).
|
detail...
|
CD274 over exp
|
lung squamous cell carcinoma
|
sensitive
|
Cemiplimab
|
Guideline |
Actionable |
Libtayo (cemiplimab) is included in guidelines as preferred first-line therapy for patients with advanced or metastatic lung squamous cell carcinoma with CD274 (PD-L1) expression of at least 50% and negative for actionable molecular biomarkers; and as continued maintenance therapy (NCCN.org).
|
detail...
|
MLH1 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
breast cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines for patients with metastatic or unresectable breast cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) who have progressed on or following prior treatment (NCCN.org).
|
detail...
|
PMS2 negative
|
colon cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as preferred primary or subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH1 act mut
|
chondrosarcoma
|
sensitive
|
Ivosidenib
|
Guideline |
Actionable |
Tibsovo (ivosidenib) is included in guidelines as systemic therapy for patients with conventional or dedifferentiated chondrosarcoma harboring an IDH1 activating mutation (NCCN.org).
|
detail...
|
CDKN2A mutant
|
skin melanoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline CDKN2A mutations or polymorphisms are associated with increased risk of developing single or multiple primary cutaneous melanomas (NCCN.org).
|
detail...
|
BRAF V600E
|
high grade glioma
|
sensitive
|
Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) is included in guidelines as adjuvant therapy for pediatric patients with diffuse high-grade gliomas harboring BRAF V600E, or as a preferred regimen for patients with recurrent or progressive disease (NCCN.org).
|
detail...
|
RET C609X
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline RET C609X mutations result in multiple endocrine neoplasia, type 2A (MEN 2A), which is associated with increased risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
RET A883X
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline RET A883X mutations result in multiple endocrine neoplasia, type 2B (MEN 2B), which is associated with high risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
IDH2 mutant
|
myelofibrosis
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
IDH2 mutations aid in the diagnosis of primary myelofibrosis in the absence of JAK2, CALR, or MPL mutations (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Obinutuzumab + Venetoclax
|
Guideline |
Actionable |
The combination of Venclexta (venetoclax) and Gazyva (obinutuzumab) is indicated in the guidelines as first line therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
FLT3 exon20
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin), in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine), is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MSH2 negative
|
pancreatic adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line or subsequent therapy for patients with locally advanced, metastatic, or recurrent pancreatic adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
NRAS mutant
|
Erdheim-Chester disease
|
sensitive
|
Cobimetinib
|
Guideline |
Actionable |
Cotellic (cobimetinib) is included in guidelines as preferred first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring mutations in the MAPK pathway such as ARAF, NRAS, KRAS, MAP2K1/2, PIK3CA, or with no detectable mutations, or for whom testing is not available (NCCN.org).
|
detail...
|
PMS2 negative
|
ovary epithelial cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as systemic therapy for patients with recurrent or advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
acute myeloid leukemia
|
sensitive
|
Quizartinib
|
Guideline |
Actionable |
Vanflyta (quizartinib) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
acute myeloid leukemia
|
sensitive
|
Gilteritinib
|
Guideline |
Actionable |
Xospata (gilteritinib) is included in the guidelines for patients with relapsed or refractory acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
BRAF V600E
|
pleomorphic xanthoastrocytoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Mekinist (trametinib) and Tafinlar (dabrafenib) combination therapy is included in guidelines as an adjuvant treatment for patients with pleomorphic xanthoastrocytoma harboring BRAF V600E (NCCN.org).
|
detail...
|
FLT3 exon16
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Cytosar-U (cytarabine) is included in guidelines as consolidation therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
RET fusion
|
medullary thyroid carcinoma
|
sensitive
|
Pralsetinib
|
Guideline |
Actionable |
Gavreto (pralsetinib) is included in guidelines as systemic therapy for patients with medullary thyroid carcinoma harboring RET fusions (NCCN.org).
|
detail...
|
MSH6 negative
|
colon cancer
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as primary or subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH1 mutant
|
oligodendroglioma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
IDH1 mutations aid in the diagnosis of oligodendrogliomas (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Atezolizumab + Carboplatin + Nab-paclitaxel
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Abraxane (nab-paclitaxel), and Tecetriq (atezolizumab) is in guidelines as first-line therapy for non-small cell lung cancer patients with CD274 (PD-L1) expression of greater than or equal to 1% (NCCN.org)
|
detail...
|
IDH2 act mut
|
astrocytoma, IDH-mutant, grade 3
|
sensitive
|
Vorasidenib
|
Guideline |
Actionable |
Voranigo (vorasidenib) is included in guidelines for patients with recurrent or progressive WHO grade 3 astrocytoma harboring an IDH2 activating mutation (NCCN.org).
|
detail...
|
FLT3 exon19
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin), in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine), is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
FLT3 mutant
|
acute myeloid leukemia
|
sensitive
|
Azacitidine + Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) in combination with Vidaza (azacitidine) is included in guidelines for adult patients with acute myeloid leukemia harboring a FLT3 mutation (NCCN.org).
|
detail...
|
MSH6 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as second-line or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) esophageal squamous cell carcinoma that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
FLT3 exon16
|
acute myeloid leukemia
|
sensitive
|
Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
NRAS mutant
|
Erdheim-Chester disease
|
sensitive
|
Trametinib
|
Guideline |
Actionable |
Mekinist (trametinib) is included in guidelines as first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring mutations in the MAPK pathway such as ARAF, NRAS, KRAS, MAP2K1/2, PIK3CA, or with no detectable mutations, or for whom testing is not available (NCCN.org).
|
detail...
|
JAK1 mutant
|
B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
JAK1 mutations are associated with a poor prognosis in patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
BRAF V600E
|
follicular thyroid carcinoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
The combination of Tafinlar (dabrafenib) and Mekinist (trametinib) is included in guidelines for patients with follicular thyroid carcinoma harboring BRAF V600E who have progressed on therapy and have no further treatment options (NCCN.org).
|
detail...
|
NRAS wild-type
|
colon cancer
|
predicted - sensitive
|
Cetuximab
|
Guideline |
Actionable |
Erbitux (cetuximab), alone and in combination with chemotherapy, is included in guidelines for patients with advanced or metastatic colon cancer that is BRAF wild-type, KRAS wild-type, and NRAS wild-type (NCCN.org).
|
detail...
|
ABL1 rearrange
|
myeloid neoplasm
|
sensitive
|
Bosutinib
|
Guideline |
Actionable |
Bosulif (bosutinib) is included in guidelines for patients with a myeloid/lymphoid neoplasm with eosinophilia harboring an ABL1 rearrangement (NCCN.org).
|
detail...
|
MSH2 negative
|
osteosarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic osteosarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 D835X
|
myelodysplastic syndrome
|
not applicable
|
N/A
|
Guideline |
Prognostic |
FLT3 D835 mutations are associated with poor prognosis in patients with myelodysplastic syndromes (NCCN.org).
|
detail...
|
MLH1 negative
|
pancreatic adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line or subsequent therapy for patients with locally advanced, metastatic, or recurrent pancreatic adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH2 act mut
|
malignant astrocytoma
|
sensitive
|
Ivosidenib
|
Guideline |
Actionable |
Tibsovo (ivosidenib) is included in guidelines for patients with astrocytoma harboring an IDH2 activating mutation (NCCN.org).
|
detail...
|
CD274 positive
|
lung large cell carcinoma
|
sensitive
|
Carboplatin + Durvalumab + Pemetrexed Disodium + Tremelimumab
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Alimta (pemetrexed disodium), Imfinzi (durvalumab), and Imjudo (tremelimumab) is in guidelines as first-line therapy for patients with advanced or metastatic large cell lung cancer, with CD274 (PD-L1) expression >/=1% - 49% (category 1) or >/= 50% (category 2B), and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MSH6 negative
|
endometrial carcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line or second-line therapy for patients with high microsatellite instability (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) recurrent endometrial carcinoma (NCCN.org).
|
detail...
|
FLT3 exon20
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Idarubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Idamycin (idarubicin) and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MLH1 negative
|
vulva cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a second-line therapy for patients with MSI high or dMMR (often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) vulva cancer (NCCN.org).
|
detail...
|
PTEN mutant
|
breast cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline PTEN mutations result in Cowden syndrome, which is associated with increased risk of developing breast cancer (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Acalabrutinib
|
Guideline |
Actionable |
Calquence (acalabrutinib) is indicated in the guidelines as second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with a TP53 mutation (NCCN.org).
|
detail...
|
CD274 positive
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with first-line chemotherapy including Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as preferred first-line therapy for patients with locally advanced, recurrent, or metastatic ERBB2 (HER2) overexpression negative gastroesophageal junction adenocarcinoma expressing PD-L1 (CD274) with CPS >/= 5 (category 1) or with CPS < 5 (category 2B) (NCCN.org).
|
detail...
|
RET fusion
|
stomach cancer
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as second-line or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer harboring RET fusion (NCCN.org). (NCCN.org).
|
detail...
|
CD274 positive
|
vaginal carcinoma
|
sensitive
|
Bevacizumab + Carboplatin + Paclitaxel + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with Paraplatin (carboplatin), Taxol (paclitaxel), and Avastin (bevacizumab) is included in guidelines as preferred first-line therapy for patients with recurrent or metastatic vaginal squamous cell carcinoma or adenocarcinoma with CD274 (PD-L1) expression (CPS >/= 1) (NCCN.org).
|
detail...
|
PMS2 negative
|
hepatocellular carcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) hepatocellular carcinoma (NCCN.org).
|
detail...
|
KMT2A rearrange
|
B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
KMT2A rearrangements (t(v;11q23.3)) aid in the diagnosis of B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
MSH2 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Durvalumab + Tremelimumab
|
Guideline |
Actionable |
Imfinzi (durvalumab), in combination with Imjudo (tremelimumab), is included in guidelines as neoadjuvant therapy for patients with gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
small intestine adenocarcinoma
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
JAK2 V617F
|
polycythemia vera
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
JAK2 V617F aids in the diagnosis of polycythemia vera (NCCN.org).
|
detail...
|
KIT act mut
|
gastrointestinal stromal tumor
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
KIT activating mutations aid the diagnosis of gastrointestinal stromal tumor (NCCN.org).
|
detail...
|
BRAF V600E
|
Adenocarcinoma of Unknown Primary
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
The combination of Tafinlar (dabrafenib) and Mekinist (trametinib) is included in guidelines for patients with adenocarcinoma of unknown primary harboring BRAF V600E (NCCN.org).
|
detail...
|
MSH6 negative
|
gallbladder cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy (category 2B) for patients with biliary tract cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including gallbladder cancer (NCCN.org).
|
detail...
|
MSH2 negative
|
stomach cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line, second-line, or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) stomach cancer that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
IDH2 mutant
|
acute myeloid leukemia
|
sensitive
|
Azacitidine + Enasidenib
|
Guideline |
Actionable |
Idhifa (enasidenib) in combination with Vidaza (azacitidine) is included in guidelines (category 2B) for patients with acute myeloid leukemia harboring an IDH2 mutation (NCCN.org).
|
detail...
|
IDH2 wild-type
|
IDH-wildtype glioblastoma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
Wild-type IDH2 aids in the diagnosis of glioblastoma (NCCN.org).
|
detail...
|
MLH1 negative
|
extrahepatic bile duct carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as primary therapy and subsequent-line therapy for patients with unresectable or metastatic biliary tract cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including extrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
RET fusion
|
cervical cancer
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as second-line or subsequent therapy for patients with cervical cancer harboring RET fusions (NCCN.org).
|
detail...
|
IDH1 mutant
|
acute myeloid leukemia
|
sensitive
|
Decitabine + Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) in combination with Dacogen (decitabine) is included in guidelines for adult patients with acute myeloid leukemia harboring an IDH1 mutation (NCCN.org).
|
detail...
|
IDH1 act mut
|
astrocytoma, IDH-mutant, grade 2
|
sensitive
|
Vorasidenib
|
Guideline |
Actionable |
Voranigo (vorasidenib) is included in guidelines as adjuvant therapy for patients with WHO grade 2 astrocytoma harboring an IDH1 activating mutation (NCCN.org).
|
detail...
|
MSH2 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
stomach cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced or metastatic gastric cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon14
|
acute myeloid leukemia
|
sensitive
|
Gilteritinib
|
Guideline |
Actionable |
Xospata (gilteritinib) is included in guidelines for patients with relapsed or refractory acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MSH2 negative
|
colon cancer
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as primary or subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
RET fusion
|
intrahepatic cholangiocarcinoma
|
sensitive
|
Pralsetinib
|
Guideline |
Actionable |
Gavreto (pralsetinib) is included in guidelines as primary (category 2B) and subsequent-line therapy (category 2B) for patients with unresectable or metastatic biliary tract cancer harboring RET fusions, including intrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
JAK3 rearrange
|
B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
JAK3 rearrangements are associated with a poor prognosis in patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
MLH1 negative
|
endometrial carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line or subsequent-line therapy for patients with recurrent or metastatic endometrial carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF V600E
|
esophagus squamous cell carcinoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) and Mekinist (trametinib) combination therapy is included in guidelines as second-line or subsequent therapy for patients with locally advanced, recurrent, or metastatic esophageal squamous cell carcinoma harboring BRAF V600E (NCCN.org).
|
detail...
|
MSH2 negative
|
bone cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a systemic therapy for patients with unresectable or metastatic bone cancer with high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
ovary epithelial cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as systemic therapy for patients with recurrent or advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
small intestine adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
STK11 mutant
|
breast cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline STK11 mutations are associated with increased risk of developing breast cancer (NCCN.org).
|
detail...
|
VHL mutant
|
islet cell tumor
|
sensitive
|
Belzutifan
|
Guideline |
Actionable |
Welireg (belzutifan) is included in guidelines for patients with well-differentiated Grade 1/2 progressive pancreatic neuroendocrine tumors harboring germline VHL mutations (NCCN.org).
|
detail...
|
PMS2 negative
|
stomach cancer
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH1 mutant
|
polycythemia vera
|
not applicable
|
N/A
|
Guideline |
Prognostic |
IDH1 mutations are associated with inferior overall survival in patients with polycythemia vera (NCCN.org).
|
detail...
|
BRAF V600K
|
skin melanoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) and Mekinist (trametinib) combination therapy is included in guidelines for melanoma patients harboring a BRAF V600 mutation, such as BRAF V600K, as neoadjuvant or adjuvant therapy for stage III disease and as systemic therapy for patients with unresectable or metastatic disease (NCCN.org).
|
detail...
|
NRAS exon2
|
colon cancer
|
resistant
|
Panitumumab
|
Guideline |
Actionable |
Vectibix (panitumumab) is not indicated for use in colon cancer patients with NRAS exon 2 mutations (NCCN.org).
|
detail...
|
MSH6 negative
|
colon cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as preferred primary or subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
ALK rearrange
|
anaplastic large cell lymphoma
|
sensitive
|
Brigatinib
|
Guideline |
Actionable |
Alunbrig (brigatinib) is included in guidelines as initial, second-line, and subsequent therapy for patients with anaplastic large cell lymphoma harboring ALK rearrangements (NCCN.org).
|
detail...
|
POLE inact mut
|
small intestine adenocarcinoma
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma harboring POLE inactivating mutations (NCCN.org).
|
detail...
|
CD274 positive
|
cervical cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as second-line therapy for patients with CD274 (PD-L1)-positive cervical cancer (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Quizartinib
|
Guideline |
Actionable |
Vanflyta (quizartinib) in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
FLT3 exon17
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin), in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine), is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
BRAF V600E
|
lung non-small cell carcinoma
|
sensitive
|
Binimetinib + Encorafenib
|
Guideline |
Actionable |
Combination of Braftovi (encorafenib) and Mektovi (binimetinib) is included in guidelines as a first-line or subsequent therapy for advanced or metastatic non-small cell lung cancer patients harboring BRAF V600E mutations (NCCN.org).
|
detail...
|
MSH6 negative
|
ovarian germ cell cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as recurrence therapy for patients with malignant ovarian germ cell tumors with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
RET fusion
|
extrahepatic bile duct carcinoma
|
sensitive
|
Pralsetinib
|
Guideline |
Actionable |
Gavreto (pralsetinib) is included in guidelines as primary (category 2B) and subsequent-line therapy (category 2B) for patients with unresectable or metastatic biliary tract cancer harboring RET fusions, including extrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
RET C630X
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline RET C630X mutations result in multiple endocrine neoplasia, type 2A (MEN 2A), which is associated with high risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
MSH2 mutant
|
endometrial carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in MSH2 result in Lynch syndrome, which is associated with increased risk of developing endometrial carcinoma (NCCN.org).
|
detail...
|
MSH2 negative
|
ovary epithelial cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
STK11 mutant
|
stomach cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in STK11 result in Peutz Jeghers syndrome, which is associated with increased risk of developing gastric cancer (NCCN.org).
|
detail...
|
NRAS exon3
|
colon cancer
|
resistant
|
Panitumumab
|
Guideline |
Actionable |
Vectibix (panitumumab) is not indicated for use in colon cancer patients with NRAS exon 3 mutations (NCCN.org).
|
detail...
|
MSH2 negative
|
rectum cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as a primary therapy for advanced or metastatic rectum cancer patients with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
rectum cancer
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as a primary therapy for advanced or metastatic rectum cancer patients with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PIK3CA mutant
|
Erdheim-Chester disease
|
sensitive
|
Cobimetinib
|
Guideline |
Actionable |
Cotellic (cobimetinib) is included in guidelines as preferred first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring mutations in the MAPK pathway such as ARAF, NRAS, KRAS, MAP2K1/2, PIK3CA, or with no detectable mutations, or for whom testing is not available (NCCN.org).
|
detail...
|
PIK3CA mutant
|
Erdheim-Chester disease
|
sensitive
|
Everolimus
|
Guideline |
Actionable |
Afinitor (everolimus) is included in guidelines as first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring PIK3CA mutations (NCCN.org).
|
detail...
|
MSH2 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
ALK rearrange
|
anaplastic large cell lymphoma
|
not applicable
|
N/A
|
Guideline |
Prognostic |
The presence of ALK rearrangement is associated with a favorable prognosis in patients with anaplastic large cell lymphoma (NCCN.org).
|
detail...
|
ALK rearrange ALK L1196M
|
lung non-small cell carcinoma
|
sensitive
|
Lorlatinib
|
Guideline |
Actionable |
Lorbrena (lorlatinib) is included in guidelines as subsequent therapy for patients with advanced or metastatic ALK-rearranged non-small cell lung cancer harboring ALK L1196M (NCCN.org).
|
detail...
|
MLH1 negative
|
extrahepatic bile duct carcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy (category 2B) for patients with biliary tract cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including extrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
MSH2 negative
|
stomach cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced or metastatic gastric cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF mutant
|
splenic marginal zone lymphoma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
BRAF mutations aid in the diagnosis of splenic marginal zone lymphoma (NCCN.org).
|
detail...
|
MSH6 negative
|
Squamous Cell Carcinoma of Unknown Primary
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with squamous cell carcinoma of unknown primary with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH2 mutant
|
anaplastic astrocytoma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
IDH2 mutations aid in the diagnosis of grade III astrocytomas (NCCN.org).
|
detail...
|
ATM inact mut
|
prostate cancer
|
sensitive
|
Enzalutamide + Talazoparib
|
Guideline |
Actionable |
Talzenna (talazoparib) plus Xtandi (enzalutamide) is included in guidelines as systemic therapy for patients with metastatic castration-resistant prostate cancer harboring a pathogenic germline or somatic ATM mutation who have not been treated in the setting of castration-resistant prostate cancer (NCCN.org).
|
detail...
|
CBL mutant
|
systemic mastocytosis
|
not applicable
|
N/A
|
Guideline |
Prognostic |
CBL mutations are associated with an adverse prognosis in patients with systemic mastocytosis (NCCN.org).
|
detail...
|
MSH2 mutant
|
colon cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Lynch syndrome results from germline mutations in DNA mismatch repair genes including MLH1, MSH2, MSH6, and PMS2, and is associated with increased risk of developing colon cancer (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Quizartinib
|
Guideline |
Actionable |
Vanflyta (quizartinib) in combination with Cytosar-U (cytarabine) is included in guidelines as consolidation therapy for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
POLE inact mut
|
colorectal cancer
|
not applicable
|
N/A
|
Guideline |
Prognostic |
POLE inactivating mutations are associated with a more favorable prognosis in patients with colorectal cancer (NCCN.org).
|
detail...
|
CD274 positive
|
vaginal carcinoma
|
sensitive
|
Bevacizumab + Cisplatin + Paclitaxel + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with Platinol (cisplatin), Taxol (paclitaxel), and Avastin (bevacizumab) is included in guidelines as preferred first-line therapy for patients with recurrent or metastatic vaginal squamous cell carcinoma or adenocarcinoma with CD274 (PD-L1) expression (CPS >/= 1) (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Carboplatin + Cemiplimab + Paclitaxel
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Taxol (paclitaxel), and Libtayo (cemiplimab) is in guidelines as first-line therapy for patients with advanced or metastatic non-small cell lung cancer with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MSH6 negative
|
ampulla of Vater adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line or subsequent therapy for metastatic ampullary adenocarcinoma patients with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 mutant
|
rectum cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Lynch syndrome results from germline mutations in DNA mismatch repair genes including MLH1, MSH2, MSH6, and PMS2, and is associated with increased risk of developing colorectal cancer (NCCN.org).
|
detail...
|
BRAF V600E
|
anaplastic oligodendroglioma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Combination of Mekinist (trametinib) and Tafinlar (dabrafenib) is included in guidelines for patients with recurrent anaplastic gliomas harboring BRAF V600E, including anaplastic oligodendroglioma (NCCN.org).
|
detail...
|
FLT3 exon 14 ins
|
acute myeloid leukemia
|
sensitive
|
Gilteritinib
|
Guideline |
Actionable |
Xospata (gilteritinib) is included in the guidelines for patients with relapsed or refractory acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
ALK rearrange
|
lung non-small cell carcinoma
|
sensitive
|
Crizotinib
|
Guideline |
Actionable |
Xalkori (crizotinib) is included in guidelines as first-line therapy for ALK rearranged non-small cell lung cancer (NCCN.org).
|
detail...
|
FLT3 exon22
|
acute myeloid leukemia
|
sensitive
|
Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MSH6 mutant
|
stomach cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in MSH6 result in Lynch syndrome, which is associated with increased risk of developing pancreatic cancer (NCCN.org).
|
detail...
|
POLE inact mut
|
rectum cancer
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as systemic therapy for patients with advanced or metastatic rectal cancer harboring POLE inactivating mutations (NCCN.org).
|
detail...
|
FLT3 mutant
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) in combination with Cytosar-U (cytarabine) is included in guidelines for adult patients with acute myeloid leukemia harboring a FLT3 mutation (NCCN.org).
|
detail...
|
BRAF V600E
|
low grade glioma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Combination of Mekinist (trametinib) and Tafinlar (dabrafenib) is included in guidelines for patients with recurrent or progressive low grade glioma harboring BRAF V600E (NCCN.org).
|
detail...
|
PMS2 negative
|
penile cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as subsequent-line systemic therapy for metastatic/recurrent penile cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
RET fusion
|
anaplastic thyroid carcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines for patients with anaplastic thyroid carcinoma harboring RET fusions (NCCN.org).
|
detail...
|
MLH1 negative
|
esophagus adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line, second-line, or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) esophageal adenocarcinoma that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
POLD1 inact mut
|
colon cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with advanced or metastatic colon cancer harboring POLD1 inactivating mutations (NCCN.org).
|
detail...
|
PMS2 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF V600X
|
skin melanoma
|
sensitive
|
Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) therapy is included in guidelines for patients with unresectable or metastatic cutaneous melanoma harboring BRAF V600 activating mutations, in cases where BRAF/MEK inhibitor combination therapy is contraindicated (NCCN.org).
|
detail...
|
CBL mutant
|
myelofibrosis
|
not applicable
|
N/A
|
Guideline |
Prognostic |
CBL mutations are associated with inferior overall survival in patients with primary myelofibrosis (NCCN.org).
|
detail...
|
BRAF V600X
|
skin melanoma
|
sensitive
|
Binimetinib + Encorafenib
|
Guideline |
Actionable |
Mektovi (binimetinib) and Braftovi (encorafenib) combination therapy is included in guidelines as a second-line or subsequent therapy for patients with metastatic or unresectable cutaneous melanoma harboring a BRAF V600 activating mutation (NCCN.org).
|
detail...
|
MSH2 negative
|
stomach cancer
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 mutant
|
endometrial carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in MLH1 result in Lynch syndrome, which is associated with increased risk of developing endometrial carcinoma (NCCN.org).
|
detail...
|
MSH2 negative
|
esophagus adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
penile cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as subsequent-line systemic therapy for metastatic/recurrent penile cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon14
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Cytosar-U (cytarabine) is included in guidelines as consolidation therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MSH6 negative
|
Adenocarcinoma of Unknown Primary
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with adenocarcinoma of unknown primary with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon 14 ins
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Idarubicin + Quizartinib
|
Guideline |
Actionable |
Vanflyta (quizartinib) in combination with Idamycin (idarubicin) and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
IDH1 act mut
|
oligodendroglioma
|
sensitive
|
Ivosidenib
|
Guideline |
Actionable |
Tibsovo (ivosidenib) is included in guidelines for patients with oligodendroglioma harboring an IDH1 activating mutation (NCCN.org).
|
detail...
|
TP53 mutant
|
essential thrombocythemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
TP53 mutations are associated with inferior leukemia-free survival in patients with essential thrombocythemia (NCCN.org).
|
detail...
|
MSH6 negative
|
extrahepatic bile duct carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as primary therapy and subsequent-line therapy for patients with unresectable or metastatic biliary tract cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including extrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
POLE inact mut
|
rectum cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for patients with advanced or metastatic rectal cancer harboring POLE inactivating mutations (NCCN.org).
|
detail...
|
MSH2 negative
|
rectum cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a preferred primary therapy for advanced or metastatic rectum cancer patients with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
ampulla of Vater adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) and Yervoy (ipilimumab) combination therapy is included in guidelines as first-line or subsequent therapy for metastatic ampullary adenocarcinoma patients with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PIK3CA mutant
|
Erdheim-Chester disease
|
sensitive
|
Trametinib
|
Guideline |
Actionable |
Mekinist (trametinib) is included in guidelines as first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring mutations in the MAPK pathway such as ARAF, NRAS, KRAS, MAP2K1/2, PIK3CA, or with no detectable mutations, or for whom testing is not available (NCCN.org).
|
detail...
|
BRAF V600E
|
high grade glioma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) in combination with Mekinist (trametinib) is included in guidelines as adjuvant therapy for pediatric patients with diffuse high-grade gliomas harboring BRAF V600E, or as a preferred regimen for patients with recurrent or progressive disease (NCCN.org).
|
detail...
|
MLH1 negative
|
ampulla of Vater adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line or subsequent therapy for metastatic ampullary adenocarcinoma patients with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
acute myeloid leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
FLT3 internal tandem duplication (FLT3-ITD) mutations are associated with inferior prognosis in acute myeloid leukemia patients with normal karyotype (NCCN.org).
|
detail...
|
FLT3 exon15
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Cytosar-U (cytarabine) is included in guidelines as consolidation therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MLH1 negative
|
sarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for soft tissue sarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), regardless of sarcoma sub-type (NCCN.org).
|
detail...
|
ALK rearrange
|
anaplastic large cell lymphoma
|
sensitive
|
Alectinib
|
Guideline |
Actionable |
Alecensa (alectinib) is included in guidelines as second-line and subsequent therapy for patients with anaplastic large cell lymphoma harboring ALK rearrangements (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is in guidelines as first-line therapy for advanced or metastatic non-small cell lung cancer patients with CD274 (PD-L1) expression 1% to 49% and as preferred first-line therapy with CD274 (PD-L1) expression of 50% or more, and negative for actionable molecular biomarkers; and as continued maintenance and subsequent therapy for patients with CD274 (PD-L1) expression of 1% or more (NCCN.org).
|
detail...
|
VHL inact mut
|
islet cell tumor
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline inactivating mutations in VHL result in von Hippel-Lindau (VHL) syndrome, which is associated with increased risk of developing pancreatic neuroendocrine tumors (NCCN.org).
|
detail...
|
ALK rearrange
|
inflammatory myofibroblastic tumor
|
sensitive
|
Crizotinib
|
Guideline |
Actionable |
Xalkori (crizotinib) is included in guidelines as first-line therapy for patients with advanced, recurrent, metastatic, or inoperable inflammatory myofibroblastic tumor harboring ALK translocations (NCCN.org).
|
detail...
|
JAK2 rearrange
|
B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
JAK2 rearrangements are associated with a poor prognosis in patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus adenocarcinoma
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
rectum cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as a primary therapy for advanced or metastatic rectum cancer patients with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Methylprednisolone + Rituximab
|
Guideline |
Actionable |
Artisone-Wyeth (methylprednisolone) combined with Rituxan (rituximab) is indicated in the guidelines as first-line therapy and second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
MSH2 negative
|
Ewing sarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic Ewing sarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
stomach cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced or metastatic gastric cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
RET fusion
|
gallbladder cancer
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as primary (category 2B) and subsequent-line therapy for patients with unresectable or metastatic biliary tract cancer harboring RET fusions, including gallbladder cancer (NCCN.org).
|
detail...
|
BRAF V600E/K
|
skin melanoma
|
sensitive
|
Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) and Cotellic (cobimetinib) combination therapy is included in cutaneous melanoma guidelines for patients with metastatic or unresectable disease harboring a BRAF V600 activating mutation (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Carboplatin + Cemiplimab + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Alimta (pemetrexed disodium), and Libtayo (cemiplimab) is in guidelines as first-line therapy for patients with advanced or metastatic non-small cell lung cancer, not otherwise specified, with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
BRAF V600E
|
follicular thyroid carcinoma
|
sensitive
|
Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) is included in guidelines for patients with recurrent, advanced, or metastatic thyroid follicular carcinoma harboring BRAF V600E for whom clinical trials are not available or appropriate (NCCN.org).
|
detail...
|
CD274 over exp
|
lung large cell carcinoma
|
sensitive
|
Cemiplimab
|
Guideline |
Actionable |
Libtayo (cemiplimab) is included in guidelines as preferred first-line therapy for patients with advanced or metastatic lung large cell carcinoma with CD274 (PD-L1) expression of at least 50% and negative for actionable molecular biomarkers; and as continued maintenance therapy (NCCN.org).
|
detail...
|
JAK3 rearrange
|
childhood B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
JAK3 rearrangements are associated with a poor prognosis in pediatric patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
BRAF V600E
|
oncocytic carcinoma of the thyroid
|
sensitive
|
Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) is included in guidelines for patients with recurrent, advanced, or metastatic thyroid Hurthle cell carcinoma harboring BRAF V600E for whom clinical trials are not available or appropriate (NCCN.org).
|
detail...
|
MLH1 negative
|
Adenocarcinoma of Unknown Primary
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines for patients with adenocarcinoma of unknown primary with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
medullary thyroid carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with medullary thyroid carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) after progression on prior treatment (NCCN.org).
|
detail...
|
MSH6 negative
|
sarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for soft tissue sarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), regardless of sarcoma sub-type (NCCN.org).
|
detail...
|
APC mutant
|
desmoid tumor
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
APC mutations aid the diagnosis of desmoid tumor (NCCN.org).
|
detail...
|
FLT3 exon22
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin), in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine), is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MSH6 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Durvalumab + Tremelimumab
|
Guideline |
Actionable |
Imfinzi (durvalumab), in combination with Imjudo (tremelimumab), is included in guidelines as neoadjuvant therapy for patients with gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
POLD1 inact mut
|
colon cancer
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as systemic therapy for patients with advanced or metastatic colon cancer harboring POLD1 inactivating mutations (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Lenalidomide + Rituximab
|
Guideline |
Actionable |
Revlimid (lenalidomide) combined with Rituxan (rituximab) is indicated in the guidelines as second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
MLH1 negative
|
gallbladder cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy (category 2B) for patients with biliary tract cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including gallbladder cancer (NCCN.org).
|
detail...
|
JAK2 mutant
|
myelofibrosis
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
JAK2 mutations aid in the diagnosis of primary myelofibrosis (NCCN.org).
|
detail...
|
ALK rearrange ALK L1196M ALK G1202R
|
lung non-small cell carcinoma
|
resistant
|
Lorlatinib
|
Guideline |
Actionable |
Lorbrena (lorlatinib) is not indicated for use as subsequent therapy for patients with advanced or metastatic ALK-rearranged non-small cell lung cancer harboring ALK L1196M and G1202R compound mutations (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Cemiplimab + Cisplatin + Paclitaxel
|
Guideline |
Actionable |
Combination Platinol (cisplatin), Taxol (paclitaxel), and Libtayo (cemiplimab) is in guidelines as first-line therapy for patients with advanced or metastatic non-small cell lung cancer with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
PMS2 negative
|
neuroendocrine tumor
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) locally advanced or metastatic well-differentiated, Grade 3 neuroendocrine tumors or unresectable or metastatic extrapulmonary poorly differentiated neuroendocrine carcinoma, large or small cell carcinoma, or mixed neuroendocrine/non-neuroendocrine neoplasms who have progressed on or following prior treatment (NCCN.org).
|
detail...
|
TP53 mutant
|
breast cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline TP53 mutations result in Li-Fraumeni syndrome, which is associated with increased risk of developing breast cancer (NCCN.org).
|
detail...
|
PMS2 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF wild-type
|
rectum cancer
|
predicted - sensitive
|
Panitumumab
|
Guideline |
Actionable |
Vectibix (panitumumab) is included in guidelines for patients with advanced or metastatic rectal cancer that is BRAF wild-type, KRAS wild-type, and NRAS wild-type (NCCN.org).
|
detail...
|
MSH6 negative
|
bone cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a systemic therapy for patients with unresectable or metastatic bone cancer with high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
esophagus adenocarcinoma
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
Squamous Cell Carcinoma of Unknown Primary
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with squamous cell carcinoma of unknown primary with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH2 R172X
|
myelodysplastic syndrome
|
not applicable
|
N/A
|
Guideline |
Prognostic |
IDH2 R172X is associated with a poor prognosis in patients with myelodysplastic syndrome (NCCN.org).
|
detail...
|
PMS2 negative
|
ampulla of Vater adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line or subsequent therapy for metastatic ampullary adenocarcinoma patients with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
head and neck cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as first-line therapy (category 2B) for patients with CD274 (PD-L1)-positive (CPS >= 20) recurrent, unresectable, or metastatic non-nasopharyngeal head and neck cancer (NCCN.org).
|
detail...
|
PMS2 negative
|
rectum cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a preferred primary therapy for advanced or metastatic rectum cancer patients with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 over exp
|
lung adenocarcinoma
|
sensitive
|
Atezolizumab
|
Guideline |
Actionable |
Tecentriq (atezolizumab) is included in guidelines as preferred first-line therapy for patients with advanced or metastatic lung adenocarcinoma with CD274 (PD-L1) expression of at least 50% and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MSH2 negative
|
endometrial carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line or subsequent-line therapy for patients with recurrent or metastatic endometrial carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Carboplatin + Durvalumab + Pemetrexed Disodium + Tremelimumab
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Alimta (pemetrexed disodium), Imfinzi (durvalumab), and Imjudo (tremelimumab) is in guidelines as first-line therapy for patients with advanced or metastatic lung adenocarcinoma, with CD274 (PD-L1) expression >/=1% - 49% (category 1) or >/= 50% (category 2B), and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
IDH2 mutant
|
acute myeloid leukemia
|
sensitive
|
Decitabine
|
Guideline |
Actionable |
Dacogen (decitabine) is included in guidelines for adult patients with acute myeloid leukemia harboring an IDH2 mutation (NCCN.org).
|
detail...
|
MSH6 negative
|
endometrial carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line or subsequent-line therapy for patients with recurrent or metastatic endometrial carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF fusion
|
pilocytic astrocytoma
|
sensitive
|
Selumetinib
|
Guideline |
Actionable |
Koselugo (selumetinib) is included in guidelines for patients with recurrent or progressive pilocytic astrocytoma harboring a BRAF fusion (NCCN.org).
|
detail...
|
FLT3 exon22
|
acute myeloid leukemia
|
sensitive
|
Gilteritinib
|
Guideline |
Actionable |
Xospata (gilteritinib) is included in guidelines for patients with relapsed or refractory acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
PMS2 negative
|
oncocytic carcinoma of the thyroid
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with Hurthle cell thyroid carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) after progression on prior treatment (NCCN.org).
|
detail...
|
MSH2 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
POLE inact mut
|
small intestine adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma harboring POLE inactivating mutations (NCCN.org).
|
detail...
|
CD274 over exp
|
lung large cell carcinoma
|
sensitive
|
Atezolizumab
|
Guideline |
Actionable |
Tecentriq (atezolizumab) is included in guidelines as preferred first-line therapy for patients with advanced or metastatic large cell lung cancer with CD274 (PD-L1) expression of at least 50% and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
BRAF V600X
|
skin melanoma
|
sensitive
|
Dabrafenib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) therapy is included in guidelines for patients with unresectable or metastatic cutaneous melanoma harboring BRAF V600 activating mutations, in cases where BRAF/MEK inhibitor combination therapy is contraindicated (NCCN.org).
|
detail...
|
MLH1 negative
|
testicular germ cell cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a third-line therapy for metastatic testicular germ cell cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
NRAS G13X
|
myelodysplastic syndrome
|
not applicable
|
N/A
|
Guideline |
Prognostic |
NRAS G13X is associated with a poor prognosis in patients with myelodysplastic syndrome (NCCN.org).
|
detail...
|
BRAF V600E
|
papillary thyroid carcinoma
|
sensitive
|
Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) is included in guidelines for patients with recurrent, advanced, or metastatic thyroid papillary carcinoma harboring BRAF V600E for whom clinical trials are not available or appropriate (NCCN.org).
|
detail...
|
NRAS Q61X
|
myelodysplastic syndrome
|
not applicable
|
N/A
|
Guideline |
Prognostic |
NRAS Q61X is associated with a poor prognosis in patients with myelodysplastic syndrome (NCCN.org).
|
detail...
|
RET fusion
|
esophagus squamous cell carcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as second-line or subsequent therapy for patients with locally advanced, recurrent, or metastatic esophageal squamous cell carcinoma harboring RET fusions (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Cytosar-U (cytarabine) is included in guidelines as consolidation therapy for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
MLH1 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
endometrial carcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line or second-line therapy for patients with high microsatellite instability (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) recurrent endometrial carcinoma (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
RET fusion
|
papillary thyroid carcinoma
|
sensitive
|
Pralsetinib
|
Guideline |
Actionable |
Gavreto (pralsetinib) is included in guidelines as systemic therapy for patients with papillary thyroid carcinoma harboring RET fusions (NCCN.org).
|
detail...
|
MSH6 negative
|
small intestine adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as a subsequent therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MLH1 negative
|
penile cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as subsequent-line systemic therapy for metastatic/recurrent penile cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF V600K
|
skin melanoma
|
sensitive
|
Atezolizumab + Cobimetinib + Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) plus Cotellic (cobimetinib) in combination with an immune checkpoint inhibitor, such as Tecentriq (atezolizumab), is included in guidelines as second-line or subsequent therapy (category 2A) for patients with metastatic or unresectable cutaneous melanoma harboring a BRAF V600 mutation, such as BRAF V600K (NCCN.org).
|
detail...
|
MSH2 negative
|
stomach cancer
|
sensitive
|
Durvalumab + Tremelimumab
|
Guideline |
Actionable |
Imfinzi (durvalumab), in combination with Imjudo (tremelimumab, is included in guidelines as neoadjuvant therapy for patients with gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH2 mutant
|
acute myeloid leukemia
|
sensitive
|
Decitabine + Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) in combination with Dacogen (decitabine) is included in guidelines for adult patients with acute myeloid leukemia harboring an IDH2 mutation (NCCN.org).
|
detail...
|
RET V804M RET Y806C
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Compound germline RET V804M and Y806C mutations result in multiple endocrine neoplasia, type 2B (MEN 2B), which is associated with high risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
PMS2 negative
|
vaginal carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as preferred second-line or subsequent therapy for patients with recurrent or metastatic vaginal squamous cell carcinoma or adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH2 mutant
|
essential thrombocythemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
The presence of at least one mutation in either SH2B3, IDH2, U2AF1, SRSF2, SF3B1, EZH2, TP53, or RUNX1 is associated with inferior overall survival in patients with essential thrombocythemia (NCCN.org).
|
detail...
|
NRAS exon4
|
colon cancer
|
resistant
|
Panitumumab
|
Guideline |
Actionable |
Vectibix (panitumumab) is not indicated for use in colon cancer patients with NRAS exon 4 mutations (NCCN.org).
|
detail...
|
IDH2 mutant
|
malignant astrocytoma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
IDH2 mutations aid in the diagnosis of grade II and grade III astrocytomas (NCCN.org).
|
detail...
|
FGFR2 fusion
|
cholangiocarcinoma
|
sensitive
|
Pemigatinib
|
Guideline |
Actionable |
Pemazyre (pemigatinib) is included in guidelines as subsequent-line therapy for patients with cholangiocarcinoma harboring FGFR2 fusions or rearrangements (NCCN.org).
|
detail...
|
ALK rearrange
|
inflammatory myofibroblastic tumor
|
sensitive
|
Ceritinib
|
Guideline |
Actionable |
Zykadia (ceritinib) is included in guidelines as first-line therapy for patients with advanced, recurrent, metastatic, or inoperable inflammatory myofibroblastic tumor harboring ALK translocations (NCCN.org).
|
detail...
|
BRAF V600E
|
papillary thyroid carcinoma
|
sensitive
|
Dabrafenib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) is included in guidelines for patients with recurrent, advanced, or metastatic thyroid papillary carcinoma harboring BRAF V600E for whom clinical trials are not available or appropriate (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Cisplatin + Pembrolizumab + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Platinol (cisplatin), Alimta (pemetrexed disodium), and Keytruda (pembrolizumab) is in guidelines as preferred first-line therapy for patients with advanced or metastatic non-small cell lung cancer, not otherwise specified, with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
IDH1 mutant
|
angioimmunoblastic T-cell lymphoma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
IDH1 mutations aid in the diagnosis of angioimmunoblastic T-cell lymphoma (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
acute myeloid leukemia
|
sensitive
|
Decitabine + Sorafenib
|
Guideline |
Actionable |
Nexavar (sorafenib) in combination with Dacogen (decitabine) is included in guidelines for patients with relapsed or refractory acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line, second-line, or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) esophageal squamous cell carcinoma that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
CD274 positive
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with first-line chemotherapy including Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as preferred first-line therapy for patients with locally advanced, recurrent, or metastatic ERBB2 (HER2) overexpression negative gastroesophageal junction adenocarcinoma expressing PD-L1 (CD274) with CPS >/= 10 (category 1) or with CPS >/=1 and <10 (category 2B) (NCCN.org).
|
detail...
|
IDH1 mutant
|
acute myeloid leukemia
|
sensitive
|
Olutasidenib
|
Guideline |
Actionable |
Rezlidhia (olutasidenib) is included in guidelines for patients with relapsed or refractory acute myeloid leukemia harboring an IDH1 mutation (NCCN.org).
|
detail...
|
BRAF V600E
|
pilocytic astrocytoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Combination of Mekinist (trametinib) and Tafinlar (dabrafenib) is included in guidelines as an adjuvant treatment for patients with pilocytic astrocytoma harboring BRAF V600E (NCCN.org).
|
detail...
|
FLT3 mutant
|
acute myeloid leukemia
|
sensitive
|
Decitabine + Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) in combination with Dacogen (decitabine) is included in guidelines for adult patients with acute myeloid leukemia harboring a FLT3 mutation (NCCN.org).
|
detail...
|
MLH1 negative
|
stomach cancer
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
ATM mutant
|
breast cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline ATM mutations are associated with increased risk of developing breast cancer (NCCN.org).
|
detail...
|
MLH1 negative
|
chondrosarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic chondrosarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF V600E
|
neuroendocrine tumor
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Mekinist (trametinib) and Tafinlar (dabrafenib) combination therapy is included in guidelines for patients with unresectable or metastatic extrapulmonary poorly differentiated neuroendocrine carcinoma, large or small cell carcinoma, or mixed neuroendocrine/non-neuroendocrine neoplasms harboring BRAF V600E who have progressed on or following prior treatment (NCCN.org).
|
detail...
|
MLH1 negative
|
esophagus adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
bone cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a systemic therapy for patients with unresectable or metastatic bone cancer with high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH1 mutant
|
acute myeloid leukemia
|
sensitive
|
Decitabine
|
Guideline |
Actionable |
Dacogen (decitabine) is included in guidelines for adult patients with acute myeloid leukemia harboring an IDH1 mutation (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Ibrutinib
|
Guideline |
Actionable |
Imbruvica (ibrutinib) is indicated in the guidelines as first line therapy and second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
MSH6 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
cervical cancer
|
sensitive
|
Carboplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) combined with Paraplatin (carboplatin) is included in guidelines as first-line therapy for patients with CD274 (PD-L1)-positive cervical cancer (NCCN.org).
|
detail...
|
RET fusion
|
oncocytic carcinoma of the thyroid
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines for patients with thyroid Hurthle cell carcinoma harboring RET fusions (NCCN.org).
|
detail...
|
BRAF V600E
|
appendix adenocarcinoma
|
sensitive
|
Cetuximab + Encorafenib
|
Guideline |
Actionable |
Braftovi (encorafenib) in combination with Erbitux (cetuximab) is included in guidelines for patients with advanced or metastatic appendiceal adenocarcinoma harboring BRAF V600E (NCCN.org).
|
detail...
|
PMS2 negative
|
stomach cancer
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH1 act mut
|
astrocytoma, IDH-mutant, grade 4
|
sensitive
|
Vorasidenib
|
Guideline |
Actionable |
Voranigo (vorasidenib) is included in guidelines for patients with recurrent or progressive WHO grade 4 astrocytoma harboring an IDH1 activating mutation (NCCN.org).
|
detail...
|
MSH2 negative
|
ovary epithelial cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as systemic therapy for patients with recurrent or advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
predicted - sensitive
|
Zanubrutinib
|
Guideline |
Actionable |
Brukinsa (zanubrutinib) is included in guidelines as first line therapy and second line therapy and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with a TP53 mutation (NCCN.org).
|
detail...
|
BRAF fusion
|
pilocytic astrocytoma
|
not applicable
|
N/A
|
Guideline |
Prognostic |
BRAF fusions are associated with indolent disease in patients with pilocytic astrocytoma (NCCN.org).
|
detail...
|
NRAS exon2
|
rectum cancer
|
resistant
|
Cetuximab
|
Guideline |
Actionable |
Erbitux (cetuximab) is not indicated for use in rectum cancer patients with NRAS exon 2 mutations (NCCN.org).
|
detail...
|
FLT3 exon 14 ins
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
MSH6 negative
|
extrahepatic bile duct carcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy (category 2B) for patients with biliary tract cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including extrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
BRAF V600E
|
anaplastic oligodendroglioma
|
sensitive
|
Cobimetinib + Vemurafenib
|
Guideline |
Actionable |
Combination of Zelboraf (vemurafenib) and Cotellic (cobimetinib) is included in guidelines for patients with recurrent anaplastic gliomas harboring BRAF V600E, including anaplastic oligodendroglioma (NCCN.org).
|
detail...
|
JAK1 rearrange
|
B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
JAK1 rearrangements are associated with a poor prognosis in patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
CD274 positive
|
lung large cell carcinoma
|
sensitive
|
Atezolizumab + Bevacizumab + Carboplatin + Paclitaxel
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Taxol (paclitaxel), Avastin (bevacizumab), and Tecentriq (atezolizumab) is in guidelines as first-line therapy for patients with advanced or metastatic large cell lung cancer with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
POLD1 inact mut
|
colorectal cancer
|
not applicable
|
N/A
|
Guideline |
Prognostic |
POLD1 inactivating mutations are associated with a more favorable prognosis in patients with colorectal cancer (NCCN.org).
|
detail...
|
MSH2 negative
|
pancreatic adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with locally advanced, metastatic, or recurrent pancreatic adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) who have not received prior immunotherapy (NCCN.org).
|
detail...
|
MLH1 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
oncocytic carcinoma of the thyroid
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with Hurthle cell thyroid carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) after progression on prior treatment (NCCN.org).
|
detail...
|
MLH1 negative
|
ovarian germ cell cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as recurrence therapy for patients with malignant ovarian germ cell tumors with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
vaginal carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as preferred second-line or subsequent therapy for patients with recurrent or metastatic vaginal squamous cell carcinoma or adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line, second-line, or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) esophageal squamous cell carcinoma that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
MLH1 negative
|
rectum cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as a primary therapy for advanced or metastatic rectum cancer patients with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
ABL1 rearrange
|
myeloid neoplasm
|
sensitive
|
Asciminib
|
Guideline |
Actionable |
Scemblix (asciminib) is included in guidelines for patients with a myeloid/lymphoid neoplasm with eosinophilia harboring an ABL1 rearrangement (NCCN.org).
|
detail...
|
JAK2 rearrange
|
myeloid neoplasm
|
sensitive
|
Ruxolitinib
|
Guideline |
Actionable |
Jakafi (ruxolitinib) is included in guidelines for patients with a myeloid/lymphoid neoplasm with eosinophilia harboring a JAK2 rearrangement (NCCN.org).
|
detail...
|
CTNNB1 mutant
|
desmoid tumor
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
CTNNB1 mutations aid the diagnosis of desmoid tumor (NCCN.org).
|
detail...
|
MSH2 negative
|
vaginal carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as preferred second-line or subsequent therapy for patients with recurrent or metastatic vaginal squamous cell carcinoma or adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
esophagus adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
neuroendocrine tumor
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) locally advanced or metastatic well-differentiated, Grade 3 neuroendocrine tumors or unresectable or metastatic extrapulmonary poorly differentiated neuroendocrine carcinoma, large or small cell carcinoma, or mixed neuroendocrine/non-neuroendocrine neoplasms who have progressed on or following prior treatment (NCCN.org).
|
detail...
|
PMS2 negative
|
prostate adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a second-line therapy for patients with advanced or metastatic prostate adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH2 wild-type
|
high grade glioma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
IDH2 wild-type is associated with increased risk of aggressive disease in patients with grade II or III infiltrative gliomas (NCCN.org).
|
detail...
|
FGFR1 rearrange
|
myeloid and lymphoid neoplasms associated with FGFR1 abnormalities
|
sensitive
|
Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) is included in guidelines for patients with a myeloid/lymphoid neoplasm with eosinophilia harboring an FGFR1 rearrangement (NCCN.org).
|
detail...
|
FGFR1 rearrange
|
B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
FGFR1 rearrangements are associated with a poor prognosis in patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
MLH1 negative
|
endometrial carcinoma
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as a second-line or subsequent-line therapy for patients with high microsatellite instability (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) recurrent endometrial carcinoma (NCCN.org).
|
detail...
|
MSH2 negative
|
endometrial carcinoma
|
sensitive
|
Avelumab
|
Guideline |
Actionable |
Bavencio (avelumab) is included in guidelines as a second-line or subsequent-line therapy for patients with high microsatellite instability (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) recurrent endometrial carcinoma (NCCN.org).
|
detail...
|
FLT3 exon23
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Idarubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Idarubicin and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
RET fusion
|
gallbladder cancer
|
sensitive
|
Pralsetinib
|
Guideline |
Actionable |
Gavreto (pralsetinib) is included in guidelines as primary (category 2B) and subsequent-line therapy (category 2B) for patients with unresectable or metastatic biliary tract cancer harboring RET fusions, including gallbladder cancer (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Carboplatin + Durvalumab + Pemetrexed Disodium + Tremelimumab
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Alimta (pemetrexed disodium), Imfinzi (durvalumab), and Imjudo (tremelimumab) is in guidelines as first-line therapy for patients with advanced or metastatic non-small cell lung cancer, not otherwise specified, with CD274 (PD-L1) expression >/=1% - 49% (category 1) or >/= 50% (category 2B), and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MLH1 negative
|
stomach cancer
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
colon cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
RET fusion
|
oncocytic carcinoma of the thyroid
|
sensitive
|
Pralsetinib
|
Guideline |
Actionable |
Gavreto (pralsetinib) is included in guidelines for patients with thyroid Hurthle cell carcinoma harboring RET fusions (NCCN.org).
|
detail...
|
TP53 mutant
|
acute myeloid leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
TP53 mutations are associated with a poor/adverse prognosis in patients with non-APL acute myeloid leukemia (NCCN.org).
|
detail...
|
MSH2 negative
|
endometrial carcinoma
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as a second-line or subsequent-line therapy for patients with high microsatellite instability (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) recurrent endometrial carcinoma (NCCN.org).
|
detail...
|
MSH6 mutant
|
small intestine adenocarcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Lynch syndrome results from germline mutations in DNA mismatch repair genes including MLH1, MSH2, MSH6, and PMS2, and is associated with increased risk of developing small bowel adenocarcinoma (NCCN.org).
|
detail...
|
CD274 over exp
|
lung non-small cell carcinoma
|
sensitive
|
Cemiplimab
|
Guideline |
Actionable |
Libtayo (cemiplimab) is included in guidelines as preferred first-line therapy for patients with advanced or metastatic non-small cell lung cancer, not otherwise specified, with CD274 (PD-L1) expression of at least 50% and negative for actionable molecular biomarkers; and as continued maintenance therapy (NCCN.org).
|
detail...
|
POLE inact mut
|
small intestine adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma harboring POLE inactivating mutations (NCCN.org).
|
detail...
|
MSH6 negative
|
vulva cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a second-line therapy for patients with MSI high or dMMR (often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) vulva cancer (NCCN.org).
|
detail...
|
POLE inact mut
|
small intestine adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as a subsequent therapy for patients with advanced or metastatic small bowel adenocarcinoma harboring POLE inactivating mutations (NCCN.org).
|
detail...
|
MSH6 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon21
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin), in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine), is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
BRAF V600E
|
esophagus adenocarcinoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) and Mekinist (trametinib) combination therapy is included in guidelines as second-line or subsequent therapy for patients with locally advanced, recurrent, or metastatic esophageal adenocarcinoma harboring BRAF V600E (NCCN.org).
|
detail...
|
IDH2 mutant
|
high grade glioma
|
not applicable
|
N/A
|
Guideline |
Prognostic |
IDH2 mutations are associated with a favorable prognosis in patients with glioma, and are associated with a survival benefit for patients treated with radiation or alkylator therapy (NCCN.org).
|
detail...
|
POLD1 inact mut
|
small intestine adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma harboring POLD1 inactivating mutations (NCCN.org).
|
detail...
|
MSH6 negative
|
small intestine adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
stomach cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
stomach cancer
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
RET fusion
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as second-line or subsequent therapy for patients with locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma harboring RET fusions (NCCN.org).
|
detail...
|
RET fusion
|
small intestine adenocarcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines for patients with metastatic small bowel adenocarcinoma with RET fusion (NCCN.org).
|
detail...
|
MSH2 negative
|
small intestine adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as a subsequent therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
lung large cell carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is in guidelines as first-line therapy for patients with advanced or metastatic large cell lung cancer with CD274 (PD-L1) expression of 1% to 49% and as preferred first-line therapy with CD274 (PD-L1) expression of 50% or more, and negative for actionable molecular biomarkers; and as continued maintenance and subsequent therapy for patients with CD274 (PD-L1) expression of 1% or more (NCCN.org).
|
detail...
|
FLT3 exon23
|
acute myeloid leukemia
|
sensitive
|
Gilteritinib
|
Guideline |
Actionable |
Xospata (gilteritinib) is included in guidelines for patients with relapsed or refractory acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Acalabrutinib + Obinutuzumab
|
Guideline |
Actionable |
Calquence (acalabrutinib) combined with Gazyva (obinutuzumab) is indicated in the guidelines as first-line therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
ROS1 fusion
|
skin melanoma
|
sensitive
|
Entrectinib
|
Guideline |
Actionable |
Rozlytrek (entrectinib) is included in guidelines as second-line therapy for metastatic or unresectable cutaneous melanoma patients with ROS1 fusions (NCCN.org).
|
detail...
|
PMS2 negative
|
cervical cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as preferred second-line or subsequent therapy for patients with cervical cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Idarubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Idamycin (idarubicin) and Cytosar-U (cytarabine) is included in guidelines for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
MLH1 negative
|
Ewing sarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic Ewing sarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
medullary thyroid carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with medullary thyroid carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) after progression on prior treatment (NCCN.org).
|
detail...
|
CD274 positive
|
head and neck cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first- and subsequent-line therapy for patients with CD274 (PD-L1)-positive (CPS >= 1) recurrent, unresectable, or metastatic non-nasopharyngeal head and neck cancer (NCCN.org).
|
detail...
|
FLT3 exon 14 ins
|
acute myeloid leukemia
|
sensitive
|
Azacitidine + Sorafenib
|
Guideline |
Actionable |
Nexavar (sorafenib) in combination with Vidaza (azacitidine) is included in guidelines for patients with relapsed or refractory acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
MSH6 negative
|
stomach cancer
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
ABL1 rearrange
|
myeloid neoplasm
|
sensitive
|
Nilotinib
|
Guideline |
Actionable |
Tasigna (nilotinib) is included in guidelines as a preferred regimen for patients with a myeloid/lymphoid neoplasm with eosinophilia harboring a ABL1 rearrangement (NCCN.org).
|
detail...
|
IDH1 mutant
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) in combination with Cytosar-U (cytarabine) is included in guidelines for adult patients with acute myeloid leukemia harboring an IDH1 mutation (NCCN.org).
|
detail...
|
PMS2 mutant
|
endometrial cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in PMS2 result in Lynch syndrome, which is associated with increased risk of developing endometrial cancer (NCCN.org).
|
detail...
|
BRAF V600E
|
skin melanoma
|
sensitive
|
Binimetinib + Encorafenib
|
Guideline |
Actionable |
Braftovi (encorafenib) in combination with Mektovi (binimetinib) is included in guidelines as first-line and second-line therapy for patients with metastatic or unresectable cutaneous melanoma harboring BRAF V600E or V600K mutations (PMID: 30959471; NCCN.org).
|
detail...
30959471
|
MLH1 negative
|
osteosarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic osteosarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon 14 ins
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Quizartinib
|
Guideline |
Actionable |
Vanflyta (quizartinib) in combination with Cytosar-U (cytarabine) is included in guidelines as consolidation therapy for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line, second-line, or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) esophageal adenocarcinoma that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
CD274 positive
|
nasopharynx carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a subsequent-line therapy for patients with CD274 (PD-L1)-positive, recurrent or metastatic nasopharynx cancer (NCCN.org).
|
detail...
|
JAK2 rearrange
|
childhood B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
JAK2 rearrangements are associated with a poor prognosis in pediatric patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
BRAF V600E
|
skin melanoma
|
sensitive
|
Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) therapy is included in guidelines for cutaneous melanoma patients with unresectable or metastatic disease harboring BRAF V600 activating mutations, such as BRAF V600E, in cases where BRAF/MEK inhibitor combination therapy is contraindicated (NCCN.org).
|
detail...
|
MSH2 negative
|
Squamous Cell Carcinoma of Unknown Primary
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with squamous cell carcinoma of unknown primary with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon17
|
acute myeloid leukemia
|
sensitive
|
Gilteritinib
|
Guideline |
Actionable |
Xospata (gilteritinib) is included in guidelines for patients with relapsed or refractory acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
ATM mutant
|
ovarian cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline ATM mutations are associated with increased risk of developing ovarian cancer (NCCN.org).
|
detail...
|
PMS2 negative
|
Adenocarcinoma of Unknown Primary
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines for patients with adenocarcinoma of unknown primary with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH1 R132H
|
high grade glioma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
IDH1 R132H is diagnostic and aids in the diagnosis of gliomas (NCCN.org).
|
detail...
|
MSH6 negative
|
colon cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
ROS1 fusion
|
skin melanoma
|
sensitive
|
Crizotinib
|
Guideline |
Actionable |
Xalkori (crizotinib) is included in guidelines as second-line therapy for metastatic or unresectable cutaneous melanoma patients with ROS1 fusions (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is in guidelines as first-line therapy for patients with advanced or metastatic lung adenocarcinoma with CD274 (PD-L1) expression of 1% to 49% and as preferred first-line therapy with CD274 (PD-L1) expression of 50% or more, and negative for actionable molecular biomarkers; and as continued maintenance and subsequent therapy for patients with CD274 (PD-L1) expression of 1% or more (NCCN.org).
|
detail...
|
PMS2 negative
|
medullary thyroid carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with medullary thyroid carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) after progression on prior treatment (NCCN.org).
|
detail...
|
PMS2 negative
|
endometrial carcinoma
|
sensitive
|
Avelumab
|
Guideline |
Actionable |
Bavencio (avelumab) is included in guidelines as a second-line or subsequent-line therapy for patients with high microsatellite instability (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) recurrent endometrial carcinoma (NCCN.org).
|
detail...
|
FLT3 exon14
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Daunorubicin + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin), in combination with Cerubidine (daunorubicin) and Cytosar-U (cytarabine), is included in guidelines for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
acute myeloid leukemia
|
sensitive
|
Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
CD274 positive
|
vulva cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a second-line therapy for patients with CD274 (PD-L1)-positive (CPS >= 1) vulva cancer (NCCN.org).
|
detail...
|
BRAF V600E
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) and Mekinist (trametinib) combination therapy is included in guidelines as second-line or subsequent therapy for patients with locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma harboring BRAF V600E (NCCN.org).
|
detail...
|
BRAF V600E
|
pleomorphic xanthoastrocytoma
|
sensitive
|
Cobimetinib + Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) and Cotellic (cobimetinib) combination therapy is included in guidelines as an adjuvant treatment for patients with pleomorphic xanthoastrocytoma harboring BRAF V600E (NCCN.org).
|
detail...
|
ALK rearrange
|
inflammatory myofibroblastic tumor
|
sensitive
|
Brigatinib
|
Guideline |
Actionable |
Alunbrig (brigatinib) is included in guidelines as first-line therapy for patients with advanced, recurrent, metastatic, or inoperable inflammatory myofibroblastic tumor harboring ALK translocations (NCCN.org).
|
detail...
|
MLH1 mutant
|
small intestine adenocarcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Lynch syndrome results from germline mutations in DNA mismatch repair genes including MLH1, MSH2, MSH6, and PMS2, and is associated with increased risk of developing small bowel adenocarcinoma (NCCN.org).
|
detail...
|
MLH1 negative
|
cervical cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as preferred second-line or subsequent therapy for patients with cervical cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line, second-line, or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) gastroesophageal junction cancer that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
CD274 positive
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Cisplatin + Fluorouracil + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with first-line chemotherapy including Adrucil (fluorouracil) and Platinol (cisplatin) is included in guidelines as preferred first-line therapy for patients with locally advanced, recurrent, or metastatic ERBB2 (HER2) overexpression negative gastroesophageal junction adenocarcinoma expressing PD-L1 (CD274) with CPS >/= 10 (category 1) or with CPS >/=1 and <10 (category 2B) (NCCN.org).
|
detail...
|
PMS2 negative
|
small intestine adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH1 mutant
|
high grade glioma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
IDH1 mutations aid in the diagnosis of gliomas (PMID: 23041832, PMID: 19755387, PMID: 19915484; NCCN.org).
|
detail...
23041832
19755387
19915484
|
PMS2 negative
|
ovarian germ cell cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as recurrence therapy for patients with malignant ovarian germ cell tumors with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
cervical cancer
|
sensitive
|
Bevacizumab + Cisplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) combined with Platinol (cisplatin) and Avastin (bevacizumab) is included in guidelines as first-line therapy for patients with CD274 (PD-L1)-positive cervical cancer (NCCN.org).
|
detail...
|
RET fusion
|
extrahepatic bile duct carcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as primary (category 2B) and subsequent-line therapy for patients with unresectable or metastatic biliary tract cancer harboring RET fusions, including extrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
TP53 mutant
|
acute myeloid leukemia
|
sensitive
|
Decitabine
|
Guideline |
Actionable |
Dacogen (decitabine) is included in guidelines for adult patients with acute myeloid leukemia harboring a TP53 mutation (NCCN.org).
|
detail...
|
PMS2 mutant
|
stomach cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in PMS2 result in Lynch syndrome, which is associated with increased risk of developing pancreatic cancer (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Obinutuzumab + Venetoclax
|
Guideline |
Actionable |
The combination of Venclexta (venetoclax) and Gazyva (obinutuzumab) is indicated in the guidelines as first line therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with a TP53 mutation (NCCN.org).
|
detail...
|
ABL1 rearrange
|
myeloid neoplasm
|
sensitive
|
Ponatinib
|
Guideline |
Actionable |
Iclusig (ponatinib) is included in guidelines for patients with a myeloid/lymphoid neoplasm with eosinophilia harboring an ABL1 rearrangement (NCCN.org).
|
detail...
|
MLH1 negative
|
chordoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic chordoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
ALK fusion
|
Erdheim-Chester disease
|
sensitive
|
Alectinib
|
Guideline |
Actionable |
Alecensa (alectinib) is included in guidelines as first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring ALK fusions (NCCN.org).
|
detail...
|
CD274 positive
|
esophagus squamous cell carcinoma
|
sensitive
|
Cisplatin + Fluorouracil + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with first-line chemotherapy including Adrucil (fluorouracil) and Platinol (cisplatin) is included in guidelines as preferred first-line therapy for patients with locally advanced, recurrent, or metastatic esophageal squamous cell carcinoma expressing PD-L1 (CD274) with CPS >/= 10 (category 1) and for patients with CPS <10 (category 2B) (NCCN.org).
|
detail...
|
CD274 positive
|
lung large cell carcinoma
|
sensitive
|
Cemiplimab + Cisplatin + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Platinol (cisplatin), Alimta (pemetrexed disodium), and Libtayo (cemiplimab) is in guidelines as first-line therapy for patients with advanced or metastatic large cell lung cancer, with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
PMS2 negative
|
papillary thyroid carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with papillary thyroid carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) after progression on prior treatment (NCCN.org).
|
detail...
|
MAP2K1 mutant
|
Erdheim-Chester disease
|
sensitive
|
Cobimetinib
|
Guideline |
Actionable |
Cotellic (cobimetinib) is included in guidelines as preferred first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring mutations in the MAPK pathway such as ARAF, NRAS, KRAS, MAP2K1/2, PIK3CA, or with no detectable mutations, or for whom testing is not available (NCCN.org).
|
detail...
|
MLH1 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Durvalumab + Tremelimumab
|
Guideline |
Actionable |
Imfinzi (durvalumab), in combination with Imjudo (tremelimumab), is included in guidelines as neoadjuvant therapy for patients with gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Cisplatin + Pembrolizumab + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Platinol (cisplatin), Alimta (pemetrexed disodium), and Keytruda (pembrolizumab) is in guidelines as preferred first-line therapy for patients with advanced or metastatic lung adenocarcinoma with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
FLT3 rearrange
|
myeloid neoplasm
|
sensitive
|
Gilteritinib
|
Guideline |
Actionable |
Xospata (gilteritinib) is included in guidelines for patients with a myeloid/lymphoid neoplasm with eosinophilia harboring a FLT3 rearrangement (NCCN.org).
|
detail...
|
ALK rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Gefitinib
|
Guideline |
Actionable |
EGFR tyrosine kinase inhibitors including Tarceva (erlotinib), Iressa (gefitinib), Gilotrif (afatinib), and Tagrisso (osimertinib) are not indicated for use as subsequent therapy in ALK rearranged non-small cell lung cancer patients who relapsed on Alecensa (alectinib), Xalkori (crizotinib), or Zykadia (ceritinib) (NCCN.org).
|
detail...
|
BRAF V600E
|
gastrointestinal stromal tumor
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) in combination with Mekinist (trametinib) is included in guidelines as neoadjuvant therapy for patients with resectable disease and as first-line systemic therapy for patients with unresectable or metastatic gastrointestinal stromal tumor (GIST) harboring BRAF V600E (NCCN.org).
|
detail...
|
MSH6 negative
|
pancreatic adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with locally advanced, metastatic, or recurrent pancreatic adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) who have not received prior immunotherapy (NCCN.org).
|
detail...
|
PMS2 negative
|
testicular germ cell cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a third-line therapy for metastatic testicular germ cell cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) is indicated in the guidelines as second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with a TP53 mutation (NCCN.org).
|
detail...
|
RET rearrange
|
lung non-small cell carcinoma
|
sensitive
|
Pralsetinib
|
Guideline |
Actionable |
Gavreto (pralsetinib) is included in guidelines as a first-line and subsequent therapy for patients with advanced or metastatic non-small cell lung cancer harboring RET rearrangements (NCCN.org).
|
detail...
|
MSH6 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as second-line or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Cemiplimab + Cisplatin + Paclitaxel
|
Guideline |
Actionable |
Combination Platinol (cisplatin), Taxol (paclitaxel), and Libtayo (cemiplimab) is in guidelines as first-line therapy for patients with advanced or metastatic lung adenocarcinoma with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MSH2 negative
|
esophagus adenocarcinoma
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CDK12 inact mut
|
prostate cancer
|
sensitive
|
Olaparib
|
Guideline |
Actionable |
Lynparza (olaparib) is included in guidelines as second-line therapy post androgen receptor-directed therapy for patients with metastatic castration-resistant prostate cancer harboring pathogenic mutations in CDK12 (NCCN.org).
|
detail...
|
TET2 mutant
|
angioimmunoblastic T-cell lymphoma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
TET2 mutations aid in the diagnosis of angioimmunoblastic T-cell lymphoma (NCCN.org).
|
detail...
|
MSH2 negative
|
stomach cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
ROS1 rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Erlotinib
|
Guideline |
Actionable |
EGFR tyrosine kinase inhibitors including Tarceva (erlotinib), Iressa (gefitinib), Gilotrif (afatinib), and Tagrisso (osimertinib) are not indicated for use as subsequent therapy in ROS1 rearranged non-small cell lung cancer patients who relapsed on Alecensa (alectinib), Xalkori (crizotinib), or Zykadia (ceritinib) (NCCN.org).
|
detail...
|
MLH1 negative
|
ampulla of Vater adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for metastatic ampullary adenocarcinoma patients with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
intrahepatic cholangiocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as primary therapy and subsequent-line therapy for patients with unresectable or metastatic biliary tract cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including intrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Atezolizumab
|
Guideline |
Actionable |
Tecentriq (atezolizumab) is included in guidelines as adjuvant therapy for non-small cell lung cancer patients with PD-L1 expression >/= 1% and negative for EGFR exon 19 deletion, L858R, or ALK rearrangements who have received prior adjuvant chemotherapy (NCCN.org).
|
detail...
|
BRAF V600E
|
colon cancer
|
sensitive
|
Encorafenib + Panitumumab
|
Guideline |
Actionable |
Braftovi (encorafenib) in combination with Vectibix (panitumumab) is included in guidelines as primary or subsequent therapy for patients with colon cancer harboring BRAF V600E (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH2 negative
|
rectum cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with advanced or metastatic rectal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
esophagus adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line, second-line, or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) esophageal adenocarcinoma that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
RET S891X
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline RET S891X mutations result in multiple endocrine neoplasia, type 2A (MEN 2A), which is associated with increased risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
MLH1 negative
|
stomach cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
RET fusion
|
colon cancer
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines for patients with metastatic colon cancer harboring RET fusions (NCCN.org).
|
detail...
|
POLE inact mut
|
rectum cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as systemic therapy for patients with advanced or metastatic rectal cancer harboring POLE inactivating mutations (NCCN.org).
|
detail...
|
TP53 loss TP53 mut
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
not applicable
|
N/A
|
Guideline |
Prognostic |
The presence of a TP53 mutation combined with TP53 loss is associated with shorter progression-free survival and overall survival with chemoimmunotherapy, fixed duration venetoclax-based regimens, and covalent BTK inhibitors in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (NCCN.org).
|
detail...
|
MLH1 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line, second-line, or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) gastroesophageal junction cancer that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
BRAF V600E
|
colon cancer
|
sensitive
|
Cetuximab + Encorafenib
|
Guideline |
Actionable |
Braftovi (encorafenib) in combination with Erbitux (cetuximab) is included in guidelines as primary or subsequent therapy for patients with colon cancer harboring BRAF V600E (NCCN.org).
|
detail...
|
CD274 positive
|
lung non-small cell carcinoma
|
sensitive
|
Cemiplimab + Cisplatin + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Platinol (cisplatin), Alimta (pemetrexed disodium), and Libtayo (cemiplimab) is in guidelines as first-line therapy for patients with advanced or metastatic non-small cell lung cancer, not otherwise specified, with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MSH6 negative
|
follicular thyroid carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines for patients with follicular thyroid carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) after progression on prior treatment (NCCN.org).
|
detail...
|
BRAF V600K
|
skin melanoma
|
sensitive
|
Vemurafenib
|
Guideline |
Actionable |
Zelboraf (vemurafenib) therapy is included in guidelines for cutaneous melanoma patients with unresectable or metastatic disease harboring BRAF V600 activating mutations, such as BRAF V600K, in cases where BRAF/MEK inhibitor combination therapy is contraindicated (NCCN.org).
|
detail...
|
JAK2 V617F
|
myelofibrosis
|
not applicable
|
N/A
|
Guideline |
Prognostic |
JAK2 V617F is associated with intermediate prognosis and higher risk of thrombosis when compared to the presence of CALR mutations in patients with primary myelofibrosis (NCCN.org).
|
detail...
|
RET fusion
|
neuroendocrine tumor
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines for patients with unresectable or metastatic extrapulmonary poorly differentiated neuroendocrine carcinoma, large or small cell carcinoma, or mixed neuroendocrine/non-neuroendocrine neoplasms harboring RET fusions who have progressed on or following prior treatment (NCCN.org).
|
detail...
|
MSH6 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line, second-line, or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) gastroesophageal junction cancer that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Zanubrutinib
|
Guideline |
Actionable |
Brukinsa (zanubrutinib) is included in guidelines as first line therapy and second line therapy and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
ALK fusion
|
Erdheim-Chester disease
|
sensitive
|
Lorlatinib
|
Guideline |
Actionable |
Lorbrena (lorlatinib) is included in guidelines as first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring ALK fusions (NCCN.org).
|
detail...
|
MSH6 negative
|
stomach cancer
|
sensitive
|
Durvalumab + Tremelimumab
|
Guideline |
Actionable |
Imfinzi (durvalumab), in combination with Imjudo (tremelimumab, is included in guidelines as neoadjuvant therapy for patients with gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
pancreatic adenocarcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line or subsequent therapy for patients with locally advanced, metastatic, or recurrent pancreatic adenocarcinoma with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Combination Opdivo (nivolumab) plus Yervoy (ipilimumab) is in guidelines as first-line or continuation maintenance therapy for advanced or metastatic lung adenocarcinoma patients with CD274 (PD-L1) expression >1% and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
KIT D816X
|
systemic mastocytosis
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
Activating mutations at codon 816 of KIT aid in the diagnosis of systemic mastocytosis (NCCN.org).
|
detail...
|
RET fusion
|
sarcoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as first-line therapy for patients with advanced or metastatic soft tissue sarcoma harboring RET fusions (NCCN.org).
|
detail...
|
POLD1 inact mut
|
small intestine adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with Yervoy (ipilimumab) is included in guidelines as an initial therapy for patients with advanced or metastatic small bowel adenocarcinoma harboring POLD1 inactivating mutations (NCCN.org).
|
detail...
|
FGFR1 rearrange
|
childhood B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
FGFR1 rearrangements are associated with a poor prognosis in pediatric patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
CD274 positive
|
lung squamous cell carcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Combination Opdivo (nivolumab) plus Yervoy (ipilimumab) is in guidelines as first-line or continuation maintenance therapy for advanced or metastatic lung squamous cell carcinoma patients with CD274 (PD-L1) expression >1% and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MSH6 negative
|
chondrosarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for metastatic chondrosarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
triple-receptor negative breast cancer
|
sensitive
|
Paclitaxel + Pembrolizumab
|
Guideline |
Actionable |
Combination of Keytruda (pembrolizumab) and Taxol (paclitaxel) is included in guidelines for patients with recurrent or metastatic CD274 (PD-L1)-positive (CPS >or= 10) triple-receptor negative breast cancer (NCCN.org).
|
detail...
|
FLT3 rearrange
|
B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
FLT3 rearrangements are associated with a poor prognosis in patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
POLD1 inact mut
|
small intestine adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as a subsequent therapy for patients with advanced or metastatic small bowel adenocarcinoma harboring POLD1 inactivating mutations (NCCN.org).
|
detail...
|
MLH1 negative
|
rectum cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a preferred primary therapy for advanced or metastatic rectum cancer patients with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
CD274 positive
|
cervical cancer
|
sensitive
|
Bevacizumab + Carboplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) combined with Paraplatin (carboplatin) and Avastin (bevacizumab) is included in guidelines as first-line therapy for patients with CD274 (PD-L1)-positive cervical cancer (NCCN.org).
|
detail...
|
MLH1 negative
|
esophagus adenocarcinoma
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Lenalidomide + Rituximab
|
Guideline |
Actionable |
Revlimid (lenalidomide) combined with Rituxan (rituximab) is indicated in the guidelines as second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with a TP53 mutation (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Alemtuzumab + Rituximab
|
Guideline |
Actionable |
Campath (alemtuzumab) combined with Rituxan (rituximab) is indicated in guidelines as therapy for patients with relapsed or refractory chronic lymphocytic leukemia/small lymphocytic lymphoma with TP53 loss who received prior treatment with a BTK inhibitor or Venclexta (venetoclax)-based therapy (NCCN.org).
|
detail...
|
CD274 positive
|
esophagus squamous cell carcinoma
|
sensitive
|
Capecitabine + Cisplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with first-line chemotherapy including Xeloda (capecitabine) and Platinol (cisplatin) is included in guidelines as preferred first-line therapy for patients with locally advanced, recurrent, or metastatic esophageal squamous cell carcinoma expressing PD-L1 (CD274) with CPS >/= 10 (category 1) and for patients with CPS <10 (category 2B) (NCCN.org).
|
detail...
|
RET fusion
|
follicular thyroid carcinoma
|
sensitive
|
Pralsetinib
|
Guideline |
Actionable |
Gavreto (pralsetinib) is included in guidelines for patients with follicular thyroid carcinoma harboring RET fusions (NCCN.org).
|
detail...
|
KMT2A rearrange
|
acute myeloid leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
KMT2A rearrangements (t(v;11q23.3)) are associated with a poor/adverse prognosis in patients with non-APL acute myeloid leukemia (NCCN.org).
|
detail...
|
MLH1 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophagus squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
POLD1 inact mut
|
colon cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for patients with advanced or metastatic colon cancer harboring POLD1 inactivating mutations (NCCN.org).
|
detail...
|
MSH2 negative
|
ampulla of Vater adenocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for metastatic ampullary adenocarcinoma patients with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus adenocarcinoma
|
sensitive
|
Fluorouracil + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
POLE inact mut
|
rectum cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with advanced or metastatic rectal cancer harboring POLE inactivating mutations (NCCN.org).
|
detail...
|
ALK rearrange
|
anaplastic large cell lymphoma
|
sensitive
|
Crizotinib
|
Guideline |
Actionable |
Xalkori (crizotinib) is included in guidelines as second-line and subsequent therapy for patients with anaplastic large cell lymphoma harboring ALK rearrangements (NCCN.org).
|
detail...
|
TP53 mutant
|
osteosarcoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in TP53 result in Li-Fraumeni syndrome, which is associated with increased risk of developing osteosarcoma (NCCN.org).
|
detail...
|
BRAF V600E
|
glioblastoma
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Combination of Mekinist (trametinib) and Tafinlar (dabrafenib) is included in guidelines for patients with recurrent glioblastoma harboring BRAF V600E (NCCN.org).
|
detail...
|
CD274 positive
|
gastric adenocarcinoma
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with a fluoropyrimidine (Adrucil (fluorouracil) or Xeloda (capecitabine)) and platinum-containing chemotherapy (Eloxatin (oxaliplatin) or Platinol (cisplatin)) is included in guidelines as a preferred first-line therapy for patients with locally advanced, unresectable, or metastatic gastric adenocarcinoma expressing CD274 (PD-L1, CPS>/=10; category 1) or CD274 (PD-L1, CPS>/=1 and <10; category 2B) and without ERBB2 (HER2) overexpression (NCCN.org).
|
detail...
|
MSH2 negative
|
sarcoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as systemic therapy for soft tissue sarcoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), regardless of sarcoma sub-type (NCCN.org).
|
detail...
|
BRAF V600E
|
salivary gland cancer
|
sensitive
|
Dabrafenib + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) and Mekinist (trametinib) combination therapy is included in guidelines for patients with recurrent, unresectable, or metastatic salivary gland tumors harboring BRAF V600E (NCCN.org).
|
detail...
|
MSH2 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Adrucil (fluorouracil) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Pirtobrutinib
|
Guideline |
Actionable |
Jaypirca (pirtobrutinib) is included in guidelines as second-line or third-line therapy for patients with chronic lymphocytic leukemia/small lymphocytic lymphoma with TP53 loss and for patients with relapsed or refractory disease after prior BTK inhibitor and Venclexta (venetoclax)-based therapy (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Alemtuzumab + Rituximab
|
Guideline |
Actionable |
Campath (alemtuzumab) combined with Rituxan (rituximab) is indicated in guidelines as therapy for patients with relapsed or refractory chronic lymphocytic leukemia/small lymphocytic lymphoma with a TP53 mutation who received prior treatment with a BTK inhibitor or Venclexta (venetoclax)-based therapy (NCCN.org).
|
detail...
|
NRAS exon3
|
colon cancer
|
resistant
|
Cetuximab
|
Guideline |
Actionable |
Erbitux (cetuximab) is not indicated for use in colon cancer patients with NRAS exon 3 mutations (NCCN.org).
|
detail...
|
MLH1 negative
|
esophagus adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
IDH2 R140Q
|
myelodysplastic syndrome
|
not applicable
|
N/A
|
Guideline |
Prognostic |
IDH2 R140Q is associated with a poor prognosis in patients with myelodysplastic syndrome (NCCN.org).
|
detail...
|
MSH6 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
RET V804M RET E805K
|
medullary thyroid carcinoma
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Compound germline RET V804M and E805K mutations result in multiple endocrine neoplasia, type 2B (MEN 2B), which is associated with high risk of developing thyroid medullary carcinoma (NCCN.org).
|
detail...
|
NRAS G12X
|
myelodysplastic syndrome
|
not applicable
|
N/A
|
Guideline |
Prognostic |
NRAS G12X is associated with a poor prognosis in patients with myelodysplastic syndrome (NCCN.org).
|
detail...
|
CTNNB1 mutant
|
medulloblastoma
|
not applicable
|
N/A
|
Guideline |
Prognostic |
WNT-driven medulloblastomas, characterized by CTNNB1 or APC mutations, are associated with favorable prognosis (NCCN.org).
|
detail...
|
JAK2 mutant
|
childhood B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
JAK2 mutations are associated with a poor prognosis in pediatric patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
RET fusion
|
ampulla of Vater adenocarcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as first-line or subsequent therapy for patients with metastatic ampullary adenocarcinoma harboring RET fusions (NCCN.org).
|
detail...
|
PMS2 negative
|
colon cancer
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Yervoy (ipilimumab), is included in guidelines as primary or subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon20
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Cytosar-U (cytarabine) is included in guidelines as consolidation therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
CD274 positive
|
head and neck squamous cell carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line therapy for patients with CD274 (PD-L1)-positive recurrent, unresectable, or metastatic non-nasopharyngeal head and neck squamous cell carcinoma (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus squamous cell carcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as first-line, second-line, or subsequent therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal squamous cell carcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 rearrange
|
childhood B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
FLT3 rearrangements are associated with a poor prognosis in pediatric patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
KIT act mut
|
skin melanoma
|
sensitive
|
Dasatinib
|
Guideline |
Actionable |
Sprycel (dasatinib) is included in guidelines as second-line therapy for metastatic or unresectable cutaneous melanoma patients with KIT activating mutations (NCCN.org).
|
detail...
|
ALK rearrange
|
anaplastic large cell lymphoma
|
sensitive
|
Ceritinib
|
Guideline |
Actionable |
Zykadia (ceritinib) is included in guidelines as initial, second-line, and subsequent therapy for patients with anaplastic large cell lymphoma harboring ALK rearrangements (NCCN.org).
|
detail...
|
ROS1 rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Brigatinib
|
Guideline |
Actionable |
Alunbrig (brigatinib) is not indicated for use in ROS1 rearranged non-small cell lung cancer patients whose disease became resistant to Xalkori (crizotinib) (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Pirtobrutinib
|
Guideline |
Actionable |
Jaypirca (pirtobrutinib) is included in guidelines as second-line or third-line therapy for patients with chronic lymphocytic leukemia/small lymphocytic lymphoma with a TP53 mutation and for patients with relapsed or refractory disease after prior BTK inhibitor and Venclexta (venetoclax)-based therapy (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
myelodysplastic syndrome
|
not applicable
|
N/A
|
Guideline |
Prognostic |
FLT3 internal tandem duplication (FLT3-ITD) mutations are associated with poor prognosis in patients with myelodysplastic syndrome (NCCN.org).
|
detail...
|
MLH1 negative
|
colon cancer
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as primary or subsequent therapy for patients with advanced or metastatic colon cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
stomach cancer
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon18
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Cytosar-U (cytarabine) is included in guidelines as consolidation therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
IDH1 mutant
|
myelodysplastic syndrome
|
sensitive
|
Olutasidenib
|
Guideline |
Actionable |
Rezlidhia (olutasidenib) with or without Vidaza (azacitidine) is included in guidelines (category 2B) for patients with myelodysplastic syndrome harboring an IDH1 mutation (NCCN.org).
|
detail...
|
POLE inact mut
|
colon cancer
|
sensitive
|
Nivolumab
|
Guideline |
Actionable |
Opdivo (nivolumab) is included in guidelines as systemic therapy for patients with advanced or metastatic colon cancer harboring POLE inactivating mutations (NCCN.org).
|
detail...
|
RET fusion
|
ovary epithelial cancer
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as systemic therapy for patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer harboring a RET fusion (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Rituximab + Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) combined with Rituxan (rituximab) is indicated in the guidelines as second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
FLT3 rearrange
|
myeloid neoplasm
|
sensitive
|
Sorafenib
|
Guideline |
Actionable |
Nexavar (sorafenib) is included in guidelines for patients with a myeloid/lymphoid neoplasm with eosinophilia harboring a FLT3 rearrangement (NCCN.org).
|
detail...
|
PMS2 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Durvalumab + Tremelimumab
|
Guideline |
Actionable |
Imfinzi (durvalumab), in combination with Imjudo (tremelimumab), is included in guidelines as neoadjuvant therapy for patients with gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
FLT3 exon 15 ins
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Idarubicin + Quizartinib
|
Guideline |
Actionable |
Vanflyta (quizartinib) in combination with Idamycin (idarubicin) and Cytosar-U (cytarabine) is included in guidelines (category 1) for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
ALK rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Nivolumab
|
Guideline |
Actionable |
Immune checkpoint inhibitors including Opdivo (nivolumab), Keytruda (pembrolizumab), Tecentriq (atezolizumab), and Imfinzi (durvalumab) are not indicated for use as subsequent therapy in non-small cell lung cancer patients with ALK rearrangement (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Idelalisib
|
Guideline |
Actionable |
Zydelig (idelalisib) is indicated in the guidelines as second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TP53 loss (NCCN.org).
|
detail...
|
TET2 mutant
|
myelofibrosis
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
TET2 mutations aid in the diagnosis of primary myelofibrosis in the absence of JAK2, CALR, or MPL mutations (NCCN.org).
|
detail...
|
FLT3 exon19
|
acute myeloid leukemia
|
sensitive
|
Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
IDH2 act mut
|
astrocytoma, IDH-mutant, grade 4
|
sensitive
|
Vorasidenib
|
Guideline |
Actionable |
Voranigo (vorasidenib) is included in guidelines for patients with recurrent or progressive WHO grade 4 astrocytoma harboring an IDH2 activating mutation (NCCN.org).
|
detail...
|
FLT3 exon20
|
acute myeloid leukemia
|
sensitive
|
Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) is included in guidelines as maintenance therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
BRAF V600E
|
appendix adenocarcinoma
|
sensitive
|
Encorafenib + Panitumumab
|
Guideline |
Actionable |
Braftovi (encorafenib) in combination with Vectibix (panitumumab) is included in guidelines for patients with advanced or metastatic appendiceal adenocarcinoma harboring BRAF V600E (NCCN.org).
|
detail...
|
KIT exon11
|
gastrointestinal stromal tumor
|
sensitive
|
Imatinib
|
Guideline |
Actionable |
Gleevec (imatinib) is included in guidelines for patients with gastrointestinal stromal tumor (GIST) harboring KIT exon 11 mutations (NCCN.org).
|
detail...
|
MLH1 negative
|
stomach cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line, second-line, or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) stomach cancer that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
CD274 positive
|
lung large cell carcinoma
|
sensitive
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Combination Opdivo (nivolumab) plus Yervoy (ipilimumab) is in guidelines as first-line or continuation maintenance therapy for advanced or metastatic large cell lung cancer patients with CD274 (PD-L1) expression >1% and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MSH2 mutant
|
pancreatic cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in MSH2 result in Lynch syndrome, which is associated with increased risk of developing pancreatic cancer (NCCN.org).
|
detail...
|
MLH1 negative
|
hepatocellular carcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy for patients with mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) hepatocellular carcinoma (NCCN.org).
|
detail...
|
FLT3 exon19
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Cytosar-U (cytarabine) is included in guidelines as consolidation therapy for patients with acute myeloid leukemia harboring a mutation in the FLT3 tyrosine kinase domain (exons 14-23) (NCCN.org).
|
detail...
|
MSH6 negative
|
esophagus adenocarcinoma
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
stomach cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as first-line, second-line, or subsequent therapy for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) stomach cancer that are unresectable, locally advanced, recurrent, or metastatic (NCCN.org).
|
detail...
|
TP53 loss
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
not applicable
|
N/A
|
Guideline |
Prognostic |
Loss of TP53 is associated with a poor prognosis in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (NCCN.org).
|
detail...
|
ATM mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
not applicable
|
N/A
|
Guideline |
Prognostic |
ATM mutations are associated with shorter time to first treatment, progression-free survival, time to next treatment, and overall survival with chemoimmunotherapy compared to wild-type ATM in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (NCCN.org).
|
detail...
|
CD274 positive
|
lung large cell carcinoma
|
sensitive
|
Carboplatin + Cemiplimab + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Alimta (pemetrexed disodium), and Libtayo (cemiplimab) is in guidelines as first-line therapy for patients with advanced or metastatic large cell lung cancer, with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
CDK12 inact mut
|
prostate cancer
|
sensitive
|
Enzalutamide + Talazoparib
|
Guideline |
Actionable |
Talzenna (talazoparib) plus Xtandi (enzalutamide) is included in guidelines as systemic therapy for patients with metastatic castration-resistant prostate cancer harboring a pathogenic germline or somatic CDK12 mutation who have not been treated in the setting of castration-resistant prostate cancer (NCCN.org).
|
detail...
|
PMS2 negative
|
esophagus adenocarcinoma
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
MSH6 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
TP53 mutant
|
medulloblastoma
|
not applicable
|
N/A
|
Guideline |
Prognostic |
TP53 mutations are associated with aggressive disease in patients with SHH-activated medulloblastoma (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Methylprednisolone + Obinutuzumab
|
Guideline |
Actionable |
Artisone-Wyeth (methylprednisolone) combined with Gazyva (obinutuzumab) is indicated in guidelines as first-line therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with a TP53 mutation and for patients with relapsed or refractory disease after prior BTK inhibitor or Venclexta (venetoclax)-based therapy (NCCN.org).
|
detail...
|
CD274 positive
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with first-line chemotherapy including Xeloda (capecitabine) and Eloxatin (oxaliplatin), is included in guidelines as preferred first-line therapy for patients with locally advanced, recurrent, or metastatic ERBB2 (HER2) overexpression negative gastroesophageal junction adenocarcinoma expressing PD-L1 (CD274) with CPS >/= 5 (category 1) or with CPS < 5 (category 2B) (NCCN.org).
|
detail...
|
RET fusion
|
pancreatic adenocarcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as first-line or subsequent therapy for patients with locally advanced, metastatic, or recurrent pancreatic adenocarcinoma harboring RET fusions (NCCN.org).
|
detail...
|
IDH1 mutant
|
acute myeloid leukemia
|
sensitive
|
Azacitidine + Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) in combination with Vidaza (azacitidine) is included in guidelines (category 1) for adult patients with acute myeloid leukemia harboring an IDH1 mutation (NCCN.org).
|
detail...
|
CD274 positive
|
gastric adenocarcinoma
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with a fluoropyrimidine (Xeloda (capecitabine) or Adrucil (fluorouracil)) and platinum-containing chemotherapy (Eloxatin (oxaliplatin) or Platinol (cisplatin)) is included in guidelines as a preferred first-line therapy for patients with locally advanced, unresectable, or metastatic gastric adenocarcinoma expressing CD274 (PD-L1, CPS>/=10; category 1) or CD274 (PD-L1, CPS>/=1 and <10; category 2B) and without ERBB2 (HER2) overexpression (NCCN.org).
|
detail...
|
ALK rearrange
|
lung non-small cell carcinoma
|
sensitive
|
Alectinib
|
Guideline |
Actionable |
Alecensa (alectinib) is included in guidelines as preferred first-line therapy and as subsequent therapy for patients with ALK-rearranged advanced or metastatic non-small cell lung cancer (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Cisplatin + Durvalumab + Pemetrexed Disodium + Tremelimumab
|
Guideline |
Actionable |
Combination Platinol (cisplatin), Alimta (pemetrexed disodium), Imfinzi (durvalumab), and Imjudo (tremelimumab) is in guidelines as first-line therapy for patients with advanced or metastatic lung adenocarcinoma, with CD274 (PD-L1) expression >/=1% - 49% (category 1) or >/= 50% (category 2B), and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MSH6 mutant
|
pancreatic cancer
|
not applicable
|
N/A
|
Guideline |
Risk Factor |
Germline mutations in MSH6 result in Lynch syndrome, which is associated with increased risk of developing pancreatic cancer (NCCN.org).
|
detail...
|
CD274 positive
|
lung squamous cell carcinoma
|
sensitive
|
Carboplatin + Ipilimumab + Nivolumab + Paclitaxel
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Taxol (paclitaxel), Opdivo (nivolumab), and Yervoy (ipilimumab) is in guidelines as first-line therapy for patients with advanced or metastatic lung squamous cell carcinoma, with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
ROS1 rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Afatinib
|
Guideline |
Actionable |
EGFR tyrosine kinase inhibitors including Tarceva (erlotinib), Iressa (gefitinib), Gilotrif (afatinib), and Tagrisso (osimertinib) are not indicated for use as subsequent therapy in ROS1 rearranged non-small cell lung cancer patients who relapsed on Alecensa (alectinib), Xalkori (crizotinib), or Zykadia (ceritinib) (NCCN.org).
|
detail...
|
CD274 positive
|
lung large cell carcinoma
|
sensitive
|
Atezolizumab + Carboplatin + Nab-paclitaxel
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Abraxane (nab-paclitaxel), and Tecetriq (atezolizumab) is in guidelines as first-line therapy for patients with large cell lung cancer with CD274 (PD-L1) expression of greater than or equal to 1%, and negative status for EGFR, ALK, ROS1, BRAF, RET, and MET exon 14 skipping mutations (NCCN.org).
|
detail...
|
NRAS exon2
|
rectum cancer
|
resistant
|
Panitumumab
|
Guideline |
Actionable |
Vectibix (panitumumab) is not indicated for use in rectum cancer patients with NRAS exon 2 mutations (NCCN.org).
|
detail...
|
FGFR3 act mut
|
bladder urothelial carcinoma
|
sensitive
|
Erdafitinib
|
Guideline |
Actionable |
Balversa (erdafitinib) is included in the guidelines for patients with advanced or metastatic urothelial carcinoma harboring susceptible Fgfr3 alterations after progression on platinum-based regimens (NCCN.org).
|
detail...
|
MSH2 negative
|
esophagus adenocarcinoma
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic esophageal adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
RET fusion
|
intrahepatic cholangiocarcinoma
|
sensitive
|
Selpercatinib
|
Guideline |
Actionable |
Retevmo (selpercatinib) is included in guidelines as primary (category 2B) and subsequent-line therapy for patients with unresectable or metastatic biliary tract cancer harboring RET fusions, including intrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
ALK rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Pembrolizumab
|
Guideline |
Actionable |
Immune checkpoint inhibitors including Opdivo (nivolumab), Keytruda (pembrolizumab), Tecentriq (atezolizumab), and Imfinzi (durvalumab) are not indicated for use as subsequent therapy in non-small cell lung cancer patients with ALK rearrangement (NCCN.org).
|
detail...
|
PMS2 negative
|
gallbladder cancer
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy (category 2B) for patients with biliary tract cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including gallbladder cancer (NCCN.org).
|
detail...
|
KIT act mut
|
skin melanoma
|
sensitive
|
Imatinib
|
Guideline |
Actionable |
Gleevec (imatinib) is included in guidelines as second-line therapy for metastatic or unresectable cutaneous melanoma patients with KIT activating mutations (NCCN.org).
|
detail...
|
CD274 positive
|
cervical cancer
|
sensitive
|
Paclitaxel + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) combined with Taxol (paclitaxel) is included in guidelines as first-line therapy for patients with CD274 (PD-L1)-positive cervical cancer (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Rituximab + Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) combined with Rituxan (rituximab) is indicated in the guidelines as second line and subsequent therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with a TP53 mutation (NCCN.org).
|
detail...
|
MLH1 negative
|
gastroesophageal junction adenocarcinoma
|
sensitive
|
Capecitabine + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab), in combination with Xeloda (capecitabine) and Eloxatin (oxaliplatin) is included in guidelines as first-line therapy for patients with unresectable locally advanced, recurrent, or metastatic gastroesophageal junction adenocarcinoma with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF wild-type
|
colon cancer
|
predicted - sensitive
|
Panitumumab
|
Guideline |
Actionable |
Vectibix (panitumumab), alone and in combination with chemotherapy, is included in guidelines for patients with advanced or metastatic colon cancer that is BRAF wild-type, KRAS wild-type, and NRAS wild-type (NCCN.org).
|
detail...
|
VHL inact mut
|
hemangioblastoma
|
sensitive
|
Belzutifan
|
Guideline |
Actionable |
Welireg (belzutifan) is included in guidelines for patients with Von Hippel-Lindau disease-associated CNS hemangioblastoma that do not require immediate surgery (NCCN.org).
|
detail...
|
CD274 positive
|
lung adenocarcinoma
|
sensitive
|
Carboplatin + Pembrolizumab + Pemetrexed Disodium
|
Guideline |
Actionable |
Combination Paraplatin (carboplatin), Alimta (pemetrexed), and Keytruda (pembrolizumab) is in guidelines as preferred first-line therapy for patients with advanced or metastatic non-small cell lung cancer, not otherwise specified, with CD274 (PD-L1) expression of 1% or more, and negative for actionable molecular biomarkers (NCCN.org).
|
detail...
|
MSH2 negative
|
extrahepatic bile duct carcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy (category 2B) for patients with biliary tract cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including extrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
PMS2 negative
|
extrahepatic bile duct carcinoma
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as primary therapy and subsequent-line therapy for patients with unresectable or metastatic biliary tract cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including extrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
PMS2 negative
|
stomach cancer
|
sensitive
|
Durvalumab + Tremelimumab
|
Guideline |
Actionable |
Imfinzi (durvalumab), in combination with Imjudo (tremelimumab, is included in guidelines as neoadjuvant therapy for patients with gastric cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Obinutuzumab
|
Guideline |
Actionable |
Gazyva (obinutuzumab) is indicated in the guidelines as first line therapy for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with a TP53 mutation (NCCN.org).
|
detail...
|
ALK fusion
|
Erdheim-Chester disease
|
sensitive
|
Crizotinib
|
Guideline |
Actionable |
Xalkori (crizotinib) is included in guidelines as first-line or subsequent-line therapy for patients with Erdheim-Chester disease harboring ALK fusions (NCCN.org).
|
detail...
|
CD274 positive
|
esophagus adenocarcinoma
|
sensitive
|
Capecitabine + Nivolumab + Oxaliplatin
|
Guideline |
Actionable |
Opdivo (nivolumab) in combination with first-line chemotherapy including Xeloda (capecitabine) and Eloxatin (oxaliplatin), is included in guidelines as preferred first-line therapy for patients with locally advanced, recurrent, or metastatic ERBB2 (HER2) overexpression negative esophageal adenocarcinoma expressing PD-L1 (CD274) with CPS >/= 5 (category 1) or with CPS < 5 (category 2B) (NCCN.org).
|
detail...
|
PMS2 negative
|
intrahepatic cholangiocarcinoma
|
sensitive
|
Dostarlimab-gxly
|
Guideline |
Actionable |
Jemperli (dostarlimab-gxly) is included in guidelines as subsequent therapy (category 2B) for patients with biliary tract cancer with deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC), including intrahepatic cholangiocarcinoma (NCCN.org).
|
detail...
|
MSH6 negative
|
testicular germ cell cancer
|
sensitive
|
Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) is included in guidelines as a third-line therapy for metastatic testicular germ cell cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (NCCN.org).
|
detail...
|
BRAF V600X
|
skin melanoma
|
sensitive
|
Dabrafenib + Pembrolizumab + Trametinib
|
Guideline |
Actionable |
Tafinlar (dabrafenib) plus Mekinist (trametinib) in combination with an immune checkpoint inhibitor, such as Keytruda (pembrolizumab), is included in guidelines as second-line or subsequent therapy (category 2A) for patients with metastatic or unresectable cutaneous melanoma harboring a BRAF V600 mutation (NCCN.org).
|
detail...
|
TP53 mutant
|
chronic lymphocytic leukemia/small lymphocytic lymphoma
|
sensitive
|
Ibrutinib + Venetoclax
|
Guideline |
Actionable |
Venclexta (venetoclax) combined with Imbruvica (ibrutinib) is indicated in guidelines as first-line (category 2A), second-line, or third-line therapy (category 2B) for chronic lymphocytic leukemia/small lymphocytic lymphoma patients with a TP53 mutation (NCCN.org).
|
detail...
|
KMT2A rearrange
|
B-cell acute lymphoblastic leukemia
|
not applicable
|
N/A
|
Guideline |
Prognostic |
KMT2A rearrangements are associated with a poor prognosis in patients with B-cell acute lymphoblastic leukemia (NCCN.org).
|
detail...
|
IDH2 mutant
|
angioimmunoblastic T-cell lymphoma
|
not applicable
|
N/A
|
Guideline |
Diagnostic |
IDH2 mutations aid in the diagnosis of angioimmunoblastic T-cell lymphoma (NCCN.org).
|
detail...
|
ALK rearrange
|
lung non-small cell carcinoma
|
no benefit
|
Ipilimumab + Nivolumab
|
Guideline |
Actionable |
Immune checkpoint inhibitors including Keytruda (pembrolizumab), Tecentriq (atezolizumab), and the combination of Opdivo (nivolumab) and Yervoy (ipilimumab) are not indicated for use as initial systemic therapy in non-small cell lung cancer patients harboring oncogenes, including ALK rearrangement (NCCN.org).
|
detail...
|
BRAF wild-type
|
rectum cancer
|
predicted - sensitive
|
Cetuximab
|
Guideline |
Actionable |
Erbitux (cetuximab), alone and in combination with chemotherapy, is included in guidelines for patients with advanced or metastatic rectal cancer that is BRAF wild-type, KRAS wild-type, and NRAS wild-type (NCCN.org).
|
detail...
|
CD274 positive
|
esophagus adenocarcinoma
|
sensitive
|
Fluorouracil + Oxaliplatin + Pembrolizumab
|
Guideline |
Actionable |
Keytruda (pembrolizumab) in combination with first-line chemotherapy including Adrucil (fluorouracil) and Eloxatin (oxaliplatin), is included in guidelines as preferred first-line therapy for patients with with locally advanced, recurrent, or metastatic ERBB2 (HER2) overexpression-negative esophageal adenocarcinoma expressing PD-L1 (CD274) with CPS >/= 10 (category 1) or with CPS >/= 1 and <10 (category 2B) (NCCN.org).
|
detail...
|
FLT3 exon 14 ins
|
acute myeloid leukemia
|
sensitive
|
Cytarabine + Midostaurin
|
Guideline |
Actionable |
Rydapt (midostaurin) in combination with Cytosar-U (cytarabine) is included in guidelines as consolidation therapy for patients with acute myeloid leukemia harboring a FLT3 internal tandem duplication (FLT3-ITD) mutation (NCCN.org).
|
detail...
|
FLT3 exon 14 ins
|
|