Test Updates

New NTRK reflex option being added to select NeoTYPE^® Solid Tumor Profiles

The majority of the NeoTYPE^® Solid Tumor Profiles include screening for NTRK rearrangements by Pan-TRK IHC followed by NTRK 1-3 fusion analysis by NGS when IHC is expressed or equivocal. Beginning Monday, March 8th clients may choose reflex testing with the NTRK1-3 FISH Panel (global or tech-only) instead of NTRK NGS Fusion Panel. This new option applies to the following NeoTYPE^® Profiles: Breast, Colorectal, Cervical, Discovery, Endometrial, Esophageal, GI Predictive, Gastric, Head & Neck, Liver/Biliary, Lung, Melanoma, Other Solid Tumor, Ovarian, Pancreas, Precision, and Thyroid.

• NTRK NGS fusion testing will remain the default method as our RNA-based assay has very high sensitivity and specificity (approaching 100%)
• Clinical impact of choosing FISH instead
• FISH results are faster, with reflexed FISH results issued ~day 8 after receipt of the NeoTYPE^® order compared to ~day 17 for reflexed NTRK NGS results
• FISH sensitivity is lower, detecting ~80% of the translocations associated with NTRK 1-3
• Billing impact of choosing FISH instead
• Please substitute FISH CPT Codes (88374x3 automated or 88377x3 manual) for the NTRK NGS Fusion Panel CPT Code (81479x1) when cases reflex to FISH

For more information about differences between NTRK testing methods, please review the March 2020 webinar by Dr. Weiss: Testing Methods to identify NTRK Gene Fusions Including NGS, FISH, and IHC.

Note: Interface clients interested in ordering the new NTRK1-3 FISH reflex options should email the interface team at InterfaceTeam@neogenomics.com for ordering details.

Molecular

Effective Monday, March 8th, NeoTYPE^® Endometrial Profile will now include testing for MLH1 Promoter Methylation.

• MLH1 promoter methylation analysis is useful to distinguish sporadic from inherited endometrial cancer in tumors that are MLH1-deficient by IHC staining and/or have high levels of microsatellite instability (MSI-H).
• There are no changes to CPT Codes or turnaround times for this test addition.