Testing Methods and Tumor Profiling

How your cancer is identified

There are many ways to diagnose cancer. Utilizing various methods can be important to creating a comprehensive understanding of your cancer and to help expose cancer in challenging situations. Your provider may order one or more method to determine your cancer's diagnosis and prognosis.

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Morphology

A microscopic examination of blood, bone marrow, or thin slices of tissue. Various routine stains are applied to help distinguish the tissue layers and components of different types of cells throughout the sample.

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Immunohistochemistry (IHC)

IHC testing is a special staining process that can identify cancer cells, the cell types, and how advanced the cancer is by the type of cells and their concentration in the sample. A pathologist needs to have an initial hunch of what the diagnosis is to form his or her next questions and choose IHC stains effectively.

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Flow Cytometry

Flow cytometry is a method that analyzes cells using fluorescent markers and light. When cells are seen this dilated way, it can help detect abnormalities and identify healthy vs. diseased cells. Flow cytometry is often used for diagnosing blood cancers, cell counting and detecting biomarkers.

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FISH/Cytogenetics

Fluorescence in situ Hybridization (FISH) and cytogenetics look for genetic changes in cells. FISH testing gives pathologists a deeper look into the genetics of a cell identifying abnormalities. This deeper look can help in determining diagnosis, prognosis and treatment selection.

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Molecular

Molecular testing is at the heart of precision medicine. Also known as genomic testing, molecular tests can uncover genetic alterations or mutations that are causing your cells to malfunction leading to the development of cancer. Molecular tests can be done alongside other laboratory tests to help diagnose, treatment plan and monitor how well a treatment is working.

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Liquid Biopsy

Liquid biopsy, also known as fluid biopsy, is the process of analyzing a sample that is primarily blood. Liquid biopsy is non-invasive and is used as a diagnostic and monitoring tool. Due to their noninvasive nature, liquid biopsies can be done more frequently by your provider if appropriate for your disease. Liquid biopsies can also help your care team validate the efficiency of your cancer treatment and identify early progression.

Tumor Profiling

Identifying a cancer’s unique hallmarks

Tumor profiling [often called genomic profiling, molecular profiling, or biomarker testing] is a laboratory test to check for gene mutations or other alterations that makeup the tumor biology and underlie the cancer growth. This information can help physicians build a personalized treatment plan based on the tumor profile.

Each patient’s cancer has a unique genetic barcode. Blood cancers (like leukemia and lymphoma) as well as solid tumor cancers (such as breast and colon cancer) can carry unique mutations. While many patients could have the same official diagnosis, such as non-small cell lung cancer (NSCLC) or acute myeloid leukemia (AML), there are often underlying genetic variations in the cancer cells that make one patient’s lung cancer or leukemia different from the next patient’s.

The contribution of cancer research and clinical trials continuously advance the cancer landscape to be able to identify a cancer’s unique biological drivers and initiate the right treatment for the right patient. This is what is known as precision medicine.

Having tumor profiling, also known as biomarker testing, is a detailed and sensitive laboratory analysis of the cancer cells. The purpose of this testing exposes specific biomarker mutations, and identify targeted therapies matched to any found mutations. Tumor profiling can help guide and identify the most effective treatment plan. NeoGenomics Laboratories provides genetic profiling of a patient’s cancer to identify its unique biological drivers and weaknesses.

Studies have shown that over 60% of patients have a detectable abnormality, with the majority being actionable and associated with a targeted therapy.

Consult with your Health Care Provider to determine if biomarker testing is best for you.

Frequently asked questions

NeoGenomics Genetic Tumor Profiles- NeoTypes

NeoGenomics Laboratories offers a suite of 30 different NeoTYPE® Cancer Profiles that cover a number of blood and solid tumor cancer diagnoses. The Profiles are designed to optimize the chances of detecting actionable biomarkers which help the care team determine the best treatment, and next steps. Of them, 27 Profiles are highly focused on specific cancers such as Brain, Colorectal, Esophageal, MDS, Lymphoma, and more, and 3 are broad Profiles that make a wider search for useful disease markers.

What are Multi-Gene Tumor Profiling Tests?

Based on the tumor profiling needs, there are different types of testing panels ranging from highly focused to comprehensive. Highly focused cancer testing profiles typically analyzes a few genes specific to that cancer type and are used more often for certain cancer types, such as lung cancer or colon cancer. Comprehensive cancer profiling tests look at hundreds of genes for diverse (or pan-cancer) solid tumors.

Who should be tested?

Testing fits into a wide variety of cancer types and medical situations.

Cancer can be very overwhelming. It is important that you and your care team understand the pros and cons of testing, treatment, and any other specific goals you may have. Nearly all cancers have identified mutations or information that can be helpful in determining your treatment, your care team may consider biomarker testing if you are seeking additional information for personalized treatment decisions.

NeoGenomics’ Cancer Profiles are appropriate for: 

  • Patients with a current diagnosis of solid tumor or blood-based cancer 
  • Patients with resistance to certain treatments 
  • Patients with aggressive or rare cancers 
  • Patients with advanced cancer when standard treatments do not apply
  • Identifying patients that could benefit from clinical trials 
Pros and Cons of testing, things to consider with your care team?

Weighing potential outcomes of the testing can help you form questions and plan next steps.

The goal of tumor profiling is to improve patient care by doing some or all of these things: 

  • Detect biological flaws susceptible to a targeted therapy, which is a drug specifically designed to use the flaw against the cancer.
  • Identify clinical trials for patients according to features of their profile.
  • Find markers that more precisely describe the diagnosis so there is more guidance to the care team about how to treat it.
  • Evaluate whether the case is likely to be more or less severe than standard cases. 

Abnormalities found should be useful for at least one of the four purposes above. The great majority of our Profiles are positive for at least one mutation, and most are positive for more than one. 

Possible drawbacks to consider are:

  • There is a chance no new or extra action plan can be created from the test results. 
  • Some preserved tumor samples are too small to provide enough tissue to complete the testing. This is rarely an issue with blood or bone marrow, though those samples can be damaged during storage or transport to the lab.
  • Clinical trials may not be open for all patients and all results, or they may be too far away.
  • Insurance may not fully cover the test, and patients may have co-payments.  If this is the case, we offer a wide range of financial assistance options, see our Billing page for more information.

Testing is complex, but NeoGenomics has been successfully providing high-complexity testing to oncologists and pathologists across the United States for over 15 years. We are a responsive, nimble company and adapt our Profiles quickly to new research and changes in medical guidelines. 

An important advantage to our patients is that NeoGenomics performs all major test methods in our own laboratories. We have expertise in many types of testing, we are not restricted and can choose the best combination of methods for our Profiles. This means our tests are built to get the most from small specimens, be conservative with costs, and save our clients’ and patients’ precious time.

My care team ordered testing, now what?

When your provider orders from NeoGenomics, we must request and/or wait to receive the specimen for testing. Upon receiving the specimen, we process the sample immediately and provide results back to your provider in the form of a report.

Our report includes information about abnormalities found, important markers that were found to be normal, whether the results help define your diagnosis more specifically, what the results might predict for severity, classes of drugs that may have an impact against your cancer, and any clinical trials you may want to consider.

We bill insurance or Medicare for most of this testing; a portion of it may be billed to the hospital in some cases. You may want to refer to the “Billing for Cancer Testing” section for more information.

For organ tumors such as lung, colorectal, breast, and other solid tumor cancers, we use part of the tissue removed during your biopsy or surgery. Most of the time we work with tissue already removed for other reasons, not from a procedure done just for this test. Your doctor’s test order authorizes us to obtain this preserved tissue from the hospital or other laboratory where it was collected or last studied.

For cancers of the blood or bone marrow, we test a small sample of newly-collected blood or bone marrow. Whether your doctor collects a blood sample or requires a bone marrow aspiration in these cases depends on the disease and your individual circumstances.

Is my insurance going to cover my testing?

We have a broad network of insurance contract and value-based relationships to provide patients with exceptional in-network and cost-effective services. If you receive a denial letter, explanation of benefit, or a bill we are here to help. See our financial assistance offerings on our Billing page.