• Test Code:
  • Department:
  • Test Synonyms:
    Solid Tumor Panel Version 4Fusion geneGene fusion
  • CPT Code(s):

The GeneTrails® Comprehensive Solid Tumor Panel (CSTP) is a next-generation sequencing (NGS) test comprised of two amplicon-based libraries (one DNA, one RNA/cDNA) used to screen for clinically informative gene alterations that are important in making therapeutic decisions, including SNVs, in/dels, copy number alterations and gene fusion events. The test can detect microsatellite instability and provides an estimate of tumor mutation burden (TMB). 

CSTP is intended for the analysis of solid tumors from patients with clinically advanced disease (stage III or IV). It covers genes that are informative for the use of FDA-approved therapies in non-small cell lung cancer (e.g. EGFR, BRAF, ALK, ROS1), colorectal cancer (KRAS, NRAS, BRAF), breast cancer (PIK3CA), and bladder cancer (FGFR2/3). In addition, it can be used to select therapies that have pan-cancer approval (e.g. pembrolizumab for MSI-high, larotrectinib and entrectinib for NTRK gene fusions; trastuzumab deruxtecan for HER2/ERBB2 amplified).

The partner-agnostic RNA gene fusion panel that is part of the CSTP encompasses all fusions for which FDA-approved therapies are available, as well as targets for ongoing clinical trials. 

The GeneTrails® Comprehensive Solid Tumor Panel has national coverage for qualifying Medicare and Medicare Advantage patients across all solid tumors.

For the full list of Genes covered by DNA Sequencing, see the Genes Covered by DNA Sequencing Table

Genes covered by RNA (cDNA) sequencing:

Fusion Gene Panel
























The test is performed on DNA and RNA extracted from tumor-rich regions of formalin-fixed/paraffin-embedded tissue. The DNA and RNA (cDNA) NGS library preparations are both based on custom QiaSeq chemistry (Qiagen) that includes unique molecular indices for the assessment of library complexity. Sequencing is performed on Illumina NextSeq500/550/2000 instruments and the data are analyzed through custom bioinformatics pipelines. The DNA library is generated by 12,796 custom-designed primer extension assays covering 898,457 base pairs across 281 cancer-related genes (all coding regions of 254 genes and hotspot regions of 27 genes). This panel is routinely sequenced to an average read depth of ~2,000, providing high sensitivity for SNVs, in/dels and copy number alterations. Variants are identified using both FreeBayes and MuTect2 algorithms in a custom sequencing analysis pipeline. Included in the panel are 203 short repeats that are used to assess microsatellite instability. TMB is estimated by determining the number of likely somatic mutations and normalizing this to mutations per megabase of sequence.

The RNA panel consists of 277 custom-designed primer extension assays covering common breakpoints across 21 genes involved in clinically informative gene fusions. Using Starfusion software, the panel can identify any partner fused to these target genes. The panel can also detect oncogenic splice variants such as EGFRvIII and MET ex14del. Using a minimum output of 300,000 unique reads, this panel achieves a high level of sensitivity.

Specimen Requirements:

  • A paraffin block or
  • 10 unstained sections of tumor (4-5 microns)(15 sections for small biopsies)
  • Contact Client Services for shipping materials and procedures at (855) 535-1522.
A REQUISITION FORM MUST ACCOMPANY ALL SAMPLES.  Please include detailed clinical information.

Test Performed (Days):

Twice weekly

Turn Around Time:

10-17 Calendar days

Shipment Sensitivity Requirements:

  • Keep specimen cool during transit, but do not ship on dry ice.
  • Please use the cold pack provided in the KDL shipping kit.
  • Ship the specimen overnight express, using the FedEx priority overnight label provided.
  • Contact Client Services for shipping materials and procedures at (855) 535-1522


  1. Shaw AT, et al. Ceritinib in ALK-rearranged non-small-cell lung cancer. N Engl J Med. 2014 Mar 27;370(13):1189-97.
  2. Shaw AT, et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med. 2013 Jun 20;368(25):2385-94.
  3. Shaw AT, et al. Crizotinib in ROS1-rearranged non-small-cell lung cancer. N Engl J Med. 2014 Nov 20;371(21):1963-71.
  4. Elisei R, et al. Cabozantinib in progressive medullary thyroid cancer J Clin Oncol. 2013 Oct 10;31(29):3639-46.
  5. Dimitriadis E, et a. BRAF alterations in pediatric low grade gliomas and mixed neuronal-glial tumor. J Neurooncol. 2013 Jul;113(3):353-8.
  6. Graham RP, et al. Fibroblast growth factor receptor 2 translocations in intrahepatic cholangiocarcinoma Hum Pathol. 2014 Aug;45(8):1630-8

Additional Info:

The Knight Cancer Institute at Oregon Health & Science University is a pioneer in the field of precision cancer medicine. The institute's director, Brian Druker, M.D., helped prove it was possible to shut down just the cells that enable cancer to grow. This breakthrough has made once-fatal forms of the disease manageable and transformed how cancer is treated. The OHSU Knight Cancer Institute is the only National Cancer Institute-designated Cancer Center between Sacramento and Seattle – an honor earned only by the nation's top cancer centers. It is headquarters for one of the National Cancer Institute's largest research collaboratives, SWOG, in addition to offering the latest treatments and technologies as well as hundreds of research studies and clinical trials.

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