While tissue samples are the standard for cancer molecular profiling, tissue can often be challenging to obtain. Surgical biopsy may be risky or impossible, the biopsy procedure may have resulted in insufficient or exhausted tissue, or the sample acquired resulted in poor quality DNA. Whatever the reason, plasma assays can provide a less invasive alternative or complement to tissue assays. Plasma assays also provide the added potential for economical and minimally invasive serial sampling.
Follow It is an amplicon-based focused liquid biopsy panel that analyzes cell-free circulating tumor DNA (ctDNA) in plasma isolated from peripheral blood. The assay is designed to detect SNVs and CNVs commonly associated with multiple solid tumor types, as well as MSI-status.
Concentrations of ctDNA vary among tumor types and among individuals. This variability in ctDNA concentration creates the need for a highly sensitive technology to detect genomic mutations at lower concentrations. The Follow It assay detects mutations down to 0.1% variant allele frequency*.
Follow It detects common, clinically relevant genomic alterations in solid tumor samples, including single-base substitutions (SNVs), small deletions, and insertions (up to 24bp). It evaluates the mutation status of tumor DNA at 337 hotspots and 26 exons in 37 known cancer-associated genes simultaneously.
Follow It targets genes for non-small cell lung cancer, melanoma, colorectal cancer, GIST, basal cell, breast cancer, endometrial, and other solid tumor cancers.
A cell-free circulating tumor DNA assay for the detection of somatic cancer mutations in multiple solid tumor types.
Follow It is beneficial when there is:
Follow It analyzes cell-free circulating tumor DNA (ctDNA) in the plasma isolated from peripheral blood. This minimally invasive assay is suitable for individuals with solid tumors
Follow It may help enhance care by monitoring disease without the risks or costs associated with painful repeat biopsies
Suspected or known relapsed disease where ctDNA testing can detect resistance mutations
Metastatic disease where ctDNA testing can track therapy response dynamically
Tissue biopsy is not possible or tissue that is insufficient or exhausted
Poor quality DNA from biopsied tissue causing molecular test failure
| Gene | Position |
|---|---|
| AKT1 | E17 |
| ALK | T1151, L1152, C1156, F1174, L1196, L1198, G1202, D1203, S1206, G1269, R1275, Y1278 |
| AR | L702, V716, S741, W742, Q784, H875, F877, T878, M896 |
| BRAF | Q201, G464, G466, F468, G469, Y472, D594, F595, G596, L597, V600, K601, part of Exon15 (V600-M620), G606 |
| CCNE | Amplification |
| CTNNB1 | D32, S33, G34, I35, H36, S37, T41, S45 |
| DDR2 | L239, I638, S768 |
| DICER1 | D1705-D1709, G1809, D1810-E1813 |
| EGFR | R108, A289, S492, P596, G598, Exon18, Exon19, Exon20, Exon21, & Amplification |
| ERBB2 | G309, S310, K753, L755, I767, D769, Exon20, & Amplification |
| ESR1 | K303, E380, S463, V534, P535, L536, Y537, D538 |
| FGFR1 | N546, K656 + Amplification |
| FGFR2 | S252, P253, W290, A315, S372, Y375, C382, N549, K659, E731, E777, & Amplification |
| FGFR3 | R248, S249, G370, S371, Y373, G380, A391, K650 |
| FOXL2 | C134 |
| GNA11 | Q209 |
| GNAQ | Q209 |
| GNAS | R201 |
| HRAS | G12, G13, Q61 |
| IDH1 | R132 |
| IDH2 | R140, R172 |
| KIT | S476, Y553, W557,, V559, V560, L576, K642, V654, T670, D816, D820, N822, Y823, A829, Exon9, Exon11, Exon13, & Amplification |
| KRAS | K5, A11, G12, G13, L19, Q22, A59, G60, Q61, K117, A146, & Amplification |
| MAP2K1(MEK1) | F53, Q56, K57, K59, V60, D67, I103, I111, C121, N122, P124, P387 |
| MAP2K2(MEK2) | F57, Q60, K61, L119, H123, G132 |
| MET | T1010, V1112, H1112, G1181, L1213, D1246, Y1248, Y1253, Exon13, Exon14, Exon14 (-50 to+25), Exon18, Amplification |
| NRAS | G12, G13, A59, G60, Q61, K117, A146 |
| NTRK1 | F589, G595, G667 |
| NTRK3 | G623, G696 |
| PDGFRA | R560-E571, P577, N659, L839-Y849, D842 |
| PIK3CA | R88, C90, R93, P104, G106, N107, R108, K111, R115, N345, R357, G364, E365, Exon6 [start to P377], C420, E453, P539, E542, E545, Q546, D549, E970, E978, M1043, N1044, A1046, H1047, G1049, & Amplification |
| POLE | Exons 9-14 (P286R, M295R, S297F, F367S, D368Y, V411L, L424I, M444K, A456P, S459F) |
| PTCH1 | W844, G1093 |
| PTEN | A126, G129, R130, R173, R233, K254-K267 |
| RET | G533, K603, C609, C611, C618, C620, C630, D631, C634, G691, E768, L790, Y791, V804, Y806, A883, R886, S904, M918, A919, Exon10, Exon 13, Exon15 |
| ROS1 | S1986, G2032, L2026 |
| STK11 | Q37, P281 |
| TP53 | Exon4, Exon5, Exon6, Exon7, Exon8, Exon9 |
| MSI | 21 Loci |
| Biomarkers detected by Plasma Follow It® | Available FDA Approved Therapy | AMP/ASCO/CAP Tier* | Resistance |
|---|---|---|---|
| AKT1 E17K | IB | ||
| ERBB2 amplification | IA | ||
| ERBB2 oncogenic mutations | IB | ||
| ESR1 oncogenic mutations | IB | ||
| FGFR1 amplification | IIC | ||
| PIK3CA oncogenic mutations | IA | ||
| MSI-H | IA |
| Biomarkers detected by Plasma Follow It® | Available FDA Approved Therapy | AMP/ASCO/CAP Tier* | Resistance |
|---|---|---|---|
| BRAF V600E | IA | ||
| ERBB2 Amplification | IA/IB | ||
| KRAS wild type | IA | ||
| KRAS and NRAS wild-type | IA | ||
| KRAS and NRAS oncogenic mutations | IA | ||
| MSI | IA |
| Biomarkers detected by Plasma Follow It® | Available FDA Approved Therapy | AMP/ASCO/CAP Tier* | Resistance |
|---|---|---|---|
| AKT1 E17K | IB | ||
| MSI/MMRd | IA | ||
| POLE |
| Biomarkers detected by Plasma Follow It® | Available FDA Approved Therapy | AMP/ASCO/CAP Tier* | Resistance |
|---|---|---|---|
| ERBB2 amplification | IA | ||
| MSI | IA |
| Biomarkers detected by Plasma Follow It® | Available FDA Approved Therapy | AMP/ASCO/CAP Tier* | Resistance |
|---|---|---|---|
| KIT oncogenic mutations | IA/IID | ||
| KIT A829, D816, D820, N822, T670, V654, Y823 | IID | ||
| KIT V654 | IID | ||
| PDGFRA oncogenic mutations | IA | ||
| PDGFRA D842 | IA |
| Biomarkers detected by Plasma Follow It® | Available FDA Approved Therapy | AMP/ASCO/CAP Tier* | Resistance |
|---|---|---|---|
| ALK oncogenic mutations | IA/IID | ||
| BRAF V600E | IA | ||
| EGFR G719 (exon 18), exon 19 deletions, S768I (exon 20), L858R, L861Q (exon21) | IA | ||
| EGFR exon 19 deletions, L858R (exon 21) | IA | ||
| EGFR exon 20 insertion, T790M (exon 20) | IA | ||
| EGFR T790M (exon 20), L858R (exon 21) | IA | ||
| EGFR C797, L718, L792, G796 | IID | ||
| EGFR exon 20 insertion | IA | ||
| EGFR exon 18 indel | IB | ||
| EGFR exon 19 insertion | IB | ||
| EGFR exon 19 & 20 insertion, L747 | IID | ||
| ERBB2 oncogenic mutations | IA | ||
| KRAS G12C | IA | ||
| MAP2K1 oncogenic mutations | IB | ||
| MET exon 14 skipping | IA | ||
| MET amplification | IA/IID |
| Biomarkers detected by Plasma Follow It® | Available FDA Approved Therapy | AMP/ASCO/CAP Tier* | Resistance |
|---|---|---|---|
| BRAF V600 | IA | ||
| BRAF V600E | IA | ||
| BRAF V600K | IA | ||
| BRAF L597, V601 | IB | ||
| KIT oncogenic mutations | IA | ||
| MAP2K1 oncogenic mutations | IB | ||
| NRAS oncogenic mutations | IB/IID |
| Biomarkers detected by Plasma Follow It® | Available FDA Approved Therapy | AMP/ASCO/CAP Tier* | Resistance |
|---|---|---|---|
| FGFR3 R248C, S249C, G370C, Y373C | IA | ||
| FGFR3 S371C, G380R, K650 | IB | ||
| HRAS oncogenic mutuations | IB |
| Biomarkers detected by Plasma Follow It® | Available FDA Approved Therapy | AMP/ASCO/CAP Tier* | Resistance |
|---|---|---|---|
| BRAF G464, G469, L597, K601 | IID | ||
| FGFR1, FGFR2, FGFR3 oncogenic mutations | IID | ||
| KRAS oncogenic mutations | IID | ||
| Microsatellite Instability-High (MSI-H) | IA | ||
| NTRK1 and NTRK3 mutations | IA | ||
| NTRK1 G595R | IID | ||
| PTEN oncogenic mutations | IID |
| Genes | 38 |
|---|---|
| Hotspots | 337 |
| Exons | 26 |
| Turnaround Time | 3-5 days |
| Mutation types | SNVs, deletions and insertions (up to 24bp), CNVs |
| Sample Type | Blood |
| Sample Requirement | 2 x 10 mL of blood in Streck tubes |
Target mutations and other genomic aberrations commonly associated with prevalent solid tumors.
Single Integrated assay, analysis, and reporting platform streamlines assay and results reporting workflow.
Review detailed interpretations, current treatment options, and available clinical trials.
Targeted amplicon-based technology provides an economical alternative to single-gene testing or hybrid capture NGS assays.
A minimally invasive option for clinical research, Follow It can also be used to observe cancer progression or detection of treatment resistance.
All Imagia Canexia Health’s assays and software are developed in our CLIA, CAP, CDPH and DAP accredited laboratory.
Brady Davis, Canexia’s SVP of Corporate Development, moderated this workshop as part of the Association for Molecular Pathology 2020 conference, bringing together four global experts in oncology and pathology. Here are four key takeaways.
Imagia Canexia Health’s Find It & Fusions panels detect mutations and gene fusion events in solid tumor tissue. Tissue profiling can be used to help inform treatment decisions or predict progression of cancer based on somatic mutations found in the tumor.
Each comprehensive report includes detailed results as well as therapeutic recommendations and expertly curated clinical trials. Our insights can help you make more informed treatment decisions.
Perform cancer genomic profiling, right from your laboratory. From mutation identification to auto-generated clinical reports, Imagia Canexia Health’s proprietary platform puts the control back in your hands.
Through an initiative called Project ACTT, Imagia Canexia Health is providing access to Follow It, our blood-based circulating tumor DNA (ctDNA) next-generation sequencing (NGS) hotspot panel. Project ACTT is currently open to patients throughout Canada via oncologist referral.