Oncomine Comprehensive Plus Panel + LOH + LST + TSI Test
About Oncomine Comprehensive Plus Panel + LOH + LST + TSI Test
| Field | Value |
|---|---|
| Also Known As | OCA Plus + LOH + LST + TAI Panel; Comprehensive Genomic Profiling with HRD Assessment; Oncomine CGP Panel with Genomic Instability Markers |
| Sample Type | Peripheral Blood (EDTA tube) |
| Fasting Required | No fasting required |
| Report Time | 35 days |
| Recommended For | Adults with solid tumours requiring treatment guidance; all genders |
| Price | Starting at ₹3,57,500 |
What Is an Oncomine Comprehensive Plus Panel + LOH + LST + TSI Test?
The Oncomine Comprehensive Plus Panel + LOH + LST + TSI test is an advanced genomic profiling test used in cancer care. It analyses over 500 cancer-related genes using next-generation sequencing (NGS) and simultaneously assesses markers of genomic instability, including loss of heterozygosity (LOH), large-scale state transitions (LST), and telomeric allelic imbalance (TSI). Oncologists use this test to guide personalised treatment decisions for patients with solid tumours. It is also referred to as the OCA Plus + LOH + LST + TAI Panel; Comprehensive Genomic Profiling with HRD Assessment; or the Oncomine CGP Panel with Genomic Instability Markers.
What Does an Oncomine Comprehensive Plus Panel + LOH + LST + TSI Test Measure?
This panel detects a wide range of genetic changes and genomic markers in tumour tissue. The table below outlines the key parameters it analyses:
| Parameter | What It Detects | Why It Matters |
|---|---|---|
| SNVs (Single Nucleotide Variants) | A single altered DNA letter in a gene | May affect how tumour cells grow or respond to drugs |
| Indels (Insertions/Deletions) | Small DNA sections added or removed | Can disrupt normal gene function |
| CNVs (Copy Number Variations) | Extra or missing copies of genes | Some cancers grow faster due to amplified gene copies |
| Gene Fusions | Two genes abnormally joined together | Can produce proteins that drive cancer growth |
| TMB (Tumour Mutational Burden) | Total number of mutations in the tumour | High TMB may predict better response to immunotherapy |
| MSI (Microsatellite Instability) | Errors in short, repetitive DNA sequences | Indicates a faulty DNA repair system; may predict immunotherapy benefit |
| HRD (Homologous Recombination Deficiency) | Defect in a key DNA repair pathway | Tumours with HRD may respond to PARP inhibitor drugs |
| LOH (Loss of Heterozygosity) | Loss of one copy of a gene region | A "genomic scar" indicating DNA repair problems |
| LST (Large-Scale State Transitions) | Chromosomal breaks between large DNA regions | Indicates significant genomic damage |
| TSI/TAI (Telomeric Allelic Imbalance) | Uneven DNA segments extending to chromosome ends | Another marker of overall genomic instability |
Why Is an Oncomine Comprehensive Plus Panel + LOH + LST + TSI Test Done?
Doctors order this test when they need a detailed picture of a tumour's genetic make-up to choose the most appropriate treatment.
Common Symptoms That May Require This Test
The following clinical situations typically lead an oncologist to request this test.
- Confirmed diagnosis of an advanced or metastatic solid tumour
- Cancer that has stopped responding to standard treatment
- Need to identify eligibility for targeted therapy or immunotherapy
- Assessment for clinical trial enrolment
- Unexplained treatment failure requiring fresh biomarker analysis
- Suspicion of hereditary cancer syndromes (e.g., BRCA-related cancers)
- Disease progression requiring updated genomic information
Conditions This Test Can Help Detect
This test can provide treatment-guiding information across several cancer types:
- Ovarian, breast, prostate, and pancreatic cancers where PARP inhibitor therapy may be relevant
- Non-small-cell lung cancer (NSCLC) with actionable gene alterations such as EGFR, ALK, or ROS1
- Colorectal, endometrial, gastric, and bile duct (cholangiocarcinoma) cancers with high MSI or TMB
- Homologous recombination deficiency (HRD) as a biomarker for platinum-based chemotherapy sensitivity
- Any solid tumour where TMB-high status may indicate eligibility for immunotherapy
How to Prepare and What to Expect
Preparation for this test is straightforward, but bringing the right documents is essential.
Do You Need to Fast?
No fasting is required before this test. You can eat and drink normally on the day of your appointment. However, always follow specific instructions provided by your doctor.
Practical Tips Before Your Test
The following steps will help ensure the sample is suitable for analysis:
- Bring a detailed clinical history including your diagnosis, symptoms, previous test results, and family history, as this is required for the test
- Carry previous histopathology reports, imaging results, and biopsy records for the pathologist's reference
- Inform your oncologist about all current medications, ongoing treatments, and any recent chemotherapy or radiation
- Ensure the tumour tissue block or slides (if already available from a prior biopsy) are ready for submission to the laboratory
Step-by-Step Procedure
The Oncomine Comprehensive Plus Panel + LOH + LST + TSI test procedure involves the following steps:
- A trained phlebotomist confirms your identity and reviews your clinical history before starting.
- A suitable vein, usually in the crook of your elbow, is cleaned with an antiseptic wipe.
- A small needle is inserted into the vein, and 2 ml of blood is drawn into a lavender-top EDTA tube.
- The needle is removed, and gentle pressure is applied to the site with a cotton swab. A small bandage is placed over the puncture.
- The labelled blood tube is stored at 2 to 8°C and transported to the laboratory for analysis.
Factors That Can Affect Accuracy
Certain factors may influence the reliability of results:
- Delayed transportation of the blood sample after collection
- Inadequate sample volume or poor sample quality
- Prior chemotherapy or radiation, which can alter the tumour's genomic profile
- Low tumour cell content in the sample, which may lead to inconclusive results
- Sample storage conditions and age, particularly for tissue samples
Understanding Your Oncomine Comprehensive Plus Panel + LOH + LST + TSI Test Results
Results from this panel require careful interpretation by a qualified oncologist or molecular pathologist. The table below outlines what each marker's findings may indicate:
| Parameter | Result Category | Interpretation |
|---|---|---|
| TMB | TMB-High: 10 or more mutations per megabase | May predict better response to immune checkpoint inhibitor therapy |
| TMB | TMB-Low: fewer than 10 mutations per megabase | Limited predicted benefit from immunotherapy based on TMB alone |
| MSI | MSI-High (MSI-H) | Indicates mismatch repair defects; patient may benefit from immunotherapy |
| MSI | MSI-Stable (MSS) | DNA mismatch repair appears intact |
| HRD/GIS | GIS positive: GIM score of 16 or above (Oncomine platform) | Indicates potential sensitivity to PARP inhibitor drugs |
| HRD/GIS | GIS negative: GIM score below 16 | Homologous recombination deficiency not detected by this marker |
| LOH Score | High: more than 10 regions of LOH larger than 15 Mb | Marker of homologous recombination deficiency |
| LST Score | High: more than 15 in diploid tumours; more than 20 in polyploid tumours | Indicates chromosomal instability |
| TAI/TSI Score | Number of allelic imbalance regions extending to subtelomere (beyond 11 Mb) | Component of the combined genomic instability score |
| Targetable Gene Alterations | Mutations in genes such as EGFR, BRAF, ALK, ROS1, NTRK, or HER2 detected | May respond to specific targeted therapies; discussed with oncologist |
Disclaimer: These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain circumstances can affect how results should be read:
- A low tumour fraction in the sample may cause the test to fail or produce results that do not accurately reflect the tumour's true genomic profile.
- Prior exposure to chemotherapy or radiation can change the tumour's mutation landscape, meaning results may differ from those obtained at initial diagnosis.
- Sample age and preservation quality can also affect DNA integrity and the reliability of findings.
How to Maintain Healthy Levels
This test guides cancer treatment decisions rather than reflecting a lifestyle-modifiable value. The following general steps support your care journey:
- Follow your oncologist's treatment plan based on the test findings and your overall clinical picture.
- If hereditary mutations such as germline BRCA1 or BRCA2 are identified, consider speaking with a genetic counsellor about implications for you and your family.
- Maintain regular follow-up appointments with your oncology team to monitor treatment response.
Lupin Diagnostics Oncomine Comprehensive Plus Panel + LOH + LST + TSI Test Price
The Oncomine Comprehensive Plus Panel + LOH + LST + TSI cost starts at ₹3,57,500 at Lupin Diagnostics. This test requires a visit to a Lupin Diagnostics centre; home collection is not available for this test. The table includes indicative prices across major Indian cities:
| City | Approximate Price (₹) |
|---|---|
| Mumbai | 357500 |
| Pune | 330000 |
| Bangalore | 330000 |
| Chennai | 330000 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Follow these steps to book the Oncomine Comprehensive Plus Panel + LOH + LST + TSI online booking:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for sample collection.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
This is an advanced NGS-based cancer genomic profiling test. It analyses over 500 cancer-related genes and measures genomic instability markers such as LOH, LST, and TSI to help oncologists choose the most appropriate targeted therapy or immunotherapy for a patient's specific tumour.
Oncologists typically recommend this test for patients with advanced or metastatic solid tumours, particularly ovarian, breast, prostate, pancreatic, and lung cancers. It is also used when standard treatments have stopped working or when a doctor needs to assess eligibility for targeted therapies or clinical trials.
LOH (loss of heterozygosity), LST (large-scale state transitions), and TSI/TAI (telomeric allelic imbalance) are all patterns of DNA damage in tumour cells. Together, these scores generate a genomic instability score that can indicate whether a tumour is likely to respond to certain treatments, such as PARP inhibitors.
The results show whether a tumour has specific mutations, a high genomic instability score, elevated TMB, or MSI-high status. Each of these findings can indicate eligibility for particular treatments, including PARP inhibitors, platinum-based chemotherapy, or immunotherapy. Your oncologist will use these results alongside your full clinical picture to recommend the most suitable approach.
At Lupin Diagnostics, the turnaround time for this test is 35 days. The report is delivered directly via email or WhatsApp once it is ready.
Tumour tissue is collected through a biopsy performed by a doctor in a hospital or clinical setting. This procedure is carried out before the sample is sent to the laboratory for processing. The test cannot be done at home, as it requires preserved tumour tissue in an FFPE block.
Oncomine Comprehensive Plus Panel + LOH + LST + TSI Test
