Explore our tests
Biomarkers
APC (adenomatous polyposis coli) gene mutation – a genetic mutation that predisposes individuals to develop colorectal tumors.
KRAS (Kirsten rat sarcoma) mutation – a genetic mutation that promotes cancer cell growth and survival in colon cancer.
BRAF (B-Raf proto-oncogene) mutation – a genetic mutation that can be used as a prognostic marker for colon cancer patients.
p53 gene mutation – a genetic mutation that suppresses cell growth and proliferation, but is often inactivated in colon cancer.
Microsatellite instability (MSI) – a genomic instability that is commonly found in hereditary nonpolyposis colon cancer (HNPCC) or Lynch syndrome.
CpG island methylator phenotype (CIMP) – a specific pattern of DNA methylation that is often found in colon cancer and can be used as a prognostic marker.
Frequency of Mutations
For Patients
Colorectal cancer usually develops in the cells that line the main cavity or lumen of our colon and usually an adenocarcinoma. In some cases it may also be a mucinous colorectal cancer. In addition there might be subtle differences in the treatment of colon cancer, depending on whether it occurs in the ascending colon or the descending colon.
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If you have early stage colon cancer
Early stage colon cancer is often surgically resectable. If you have early colon cancer, you will most likely have a surgery to remove the tumor from your body. Subsequent to surgery, your doctor may prescribe certain adjuvant i.e. additional or helper therapy to attack any last few tumor cells. MSI (Microsatellite Instability) testing is a measure of how well the tumor is likely to respond to chemotherapy. In addition, it is also a marker of response to immunotherapy. In certain cases, immunotherapy may be considered in the pre-surgery i.e. neoadjuvant setting, in order to facilitate better outcomes from surgery. Strand’s genetic tests can help determine if your tumor is MSI-high or low.
If you have locally advanced or metastatic colon cancer
In late stage colorectal cancer, in addition to chemotherapy, targeted therapy is also frequently administered. Genetic testing of the tumor tissue can inform decisions about the choice of targeted therapy given. If you have locally advanced or metastatic colon cancer, your physician will recommend genetic testing for a few genes that can help decide which targeted therapy is most likely to be effective. Then biomarkers graph above shows the genes that are relevant for targeted therapy selection in colorectal cancer. Strand’s genetic tests can determine if any of these genes are mutated in your tumor.
Another class of drugs which is used in colorectal cancer is immunotherapy. Immunotherapy drugs help in activation of the immune system so that it can fight the cancer and have been seen to be very effective in certain cases. Immunotherapy can be considered when mutational profiling does not identify key genes with therapeutic targets. There are a few markers for assessing potential response to immunotherapy. Some of these are MSI (Microsatellite Instability) and TMB (Tumor Mutational Burden). Microsatellite instability and Tumor Mutational Burden are measures of a tumor’s immunogenicity, or foreignness in a sense, that can be measured by genetic profiling. A high MSI or TMB score indicates that the chances for a favorable response to immunotherapy are higher. Your doctor might order these tests if he or she is considering an immunotherapy regimen for you.
If you have unresponsive disease or are interested in novel therapy options
Sometimes a tumour, despite being given appropriate treatment, does not respond well to the therapeutic regimen. In such cases you and the clinician might want to consider other targeted therapy options if available. It may be useful to profile these tumours with a broad large panel of genes that are mutated across a variety of cancers as there may be a possibility that one of them is also mutated in your tumour. If such a gene is identified, it may open up additional avenues of treatment with targeted therapy. Hence,you and your doctor may consider Strand’s large panel genetic tests for such cancers if you would like to explore other potential treatment options. Large panel testing can also help determine your suitability for immunotherapy by measuring the Tumour Mutational Burden (TMB) and Microsatellite Instability (MSI). Both these are a measure of the immunogenicity of the tumour i.e. how well it can be recognized and attacked by the immune system. Large panels can also be used at the outset if you are interested in comprehensively understanding a tumour’s genetic makeup before starting treatment.
Test Portfolio
Test Name
No.of genes
Select
Lynch Syndrome Panel
5
MSI/MMR by IHC
4
Final Diagnosis Panel (by IHC)
1
KRAS Gene Analysis by PCR
1
KRAS ,NRAS & BRAF BY PCR
1
Colorectal Cancer Essential Panel
7
Colorectal Cancer Actionable Panel
8
Colorectal Cancer Comprehensive Panel
23
Comprehensive Genomic Profiling – StrandAdvantage 500 Advanced (DNA+RNA)
523
Comprehensive Genomic Profiling – StrandAdvantage 500 Basic (DNA)
523
We provide genetic counselling to help you understand your test reports
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Our certified genetic counselors will guide you through the test details and possible outcomes based on your family history.
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Our genetic counselors will walk you through your genetic test report and explain the implications of your results and further plan of action