Solid Tumour Combo2 [MSI, NRAS, KRAS, BRAF, HRAS] Test: Booking, Price, and Results
About Solid Tumour Combo2 [MSI, NRAS, KRAS, BRAF, HRAS] Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | Solid Tumour Combo Panel 2 Test, MSI/RAS/RAF Mutation Panel Test, Tumour Biomarker Panel Test |
| Sample Type | FFPE Tissue Block |
| Fasting Required | No |
| Report Time | 20 Days |
| Recommended For | Adults with diagnosed solid tumours (colorectal, lung, melanoma, thyroid, pancreatic, head and neck cancers) requiring targeted therapy guidance |
| Price | Starting at ₹28,800 |
What is a Solid Tumour Combo2 [MSI, NRAS, KRAS, BRAF, HRAS] Test?
The Solid Tumour Combo2 test is a molecular oncology panel that analyses tumour tissue for five key genetic biomarkers: MSI, NRAS, KRAS, BRAF, and HRAS. It is ordered by oncologists to guide treatment decisions for patients with confirmed solid tumours.
The sample used is a formalin-fixed paraffin-embedded (FFPE) tissue block, typically obtained from a prior biopsy or surgical procedure. This test is also referred to as the Solid Tumour Combo Panel 2 test and the MSI/RAS/RAF Mutation Panel test.
What Does a Solid Tumour Combo2 [MSI, NRAS, KRAS, BRAF, HRAS] Test Measure?
This panel examines five distinct genetic markers in cancer tissue. Each marker provides specific information about the tumour's behaviour and its likely response to treatment.
| Marker | What It Assesses |
|---|---|
| MSI (Microsatellite Instability) | Detects defects in the DNA mismatch repair system, which corrects errors in DNA copying |
| KRAS | Identifies mutations in a gene that controls cell growth signals; certain mutations predict poor response to specific drugs |
| NRAS | Detects changes in another RAS family gene that, when altered, can cause cells to grow abnormally |
| BRAF | Assesses a gene encoding a protein involved in cell signalling pathways that promote tumour growth and survival |
| HRAS | Identifies mutations in a third RAS family proto-oncogene that regulates cell growth, differentiation, and survival |
Why is a Solid Tumour Combo2 [MSI, NRAS, KRAS, BRAF, HRAS] Test Done?
This test is prescribed when an oncologist needs detailed genetic information about a tumour to plan the most appropriate course of treatment.
Common Symptoms That May Require This Test
A doctor may recommend the Solid Tumour Combo2 test when a patient presents with signs that suggest a solid tumour. These symptoms include:
- Unexplained or rapid weight loss
- Persistent changes in bowel habits
- Blood in the stool or rectal bleeding
- Chronic abdominal pain without a clear cause
- Skin lesions or moles that are growing or changing in appearance
- Difficulty swallowing
- Unexplained fatigue alongside other digestive symptoms
Conditions This Test Can Help Detect
This panel helps identify genetic features relevant to several cancer types. Conditions assessed or guided by this test include:
- Metastatic colorectal cancer (for which this combination of biomarkers is a standard-of-care test)
- Lynch syndrome, a hereditary condition linked to colorectal and other cancers
- Melanoma with BRAF mutations
- Non-small cell lung cancer (NSCLC)
- Thyroid carcinoma
- Pancreatic cancer
- Head and neck cancers, particularly those involving HRAS mutations
Solid Tumour Combo2 [MSI, NRAS, KRAS, BRAF, HRAS] Test for Chronic Disease Monitoring
Patients receiving targeted therapies such as anti-EGFR agents, BRAF inhibitors, or immunotherapy may need this test repeated over the course of their treatment. Repeat testing can identify acquired resistance mutations that develop in response to treatment. The decision to retest depends on treatment response and disease progression, and is guided by the treating oncologist.
How to Prepare and What to Expect
Preparation for this test is minimal for the patient, as the tissue sample is usually collected during a separate biopsy or surgery. The steps below explain what happens from tissue collection through to result delivery.
Do You Need to Fast?
No fasting is required for this test.
Practical Tips Before Your Test
There are a few points to keep in mind before your sample is submitted for testing:
- Bring a detailed clinical history, including your symptoms, previous test results, and treatment records, as this is required for the test
- Inform your oncologist about all current medications, particularly any chemotherapy drugs, as these may affect tumour tissue quality
- The tissue block should ideally be less than 60 days old from the date of sectioning to the date of testing
- Ensure the FFPE tissue block is handled and transported carefully according to your pathology team's instructions
- The tissue sample must contain more than 20% tumour cells to produce a result; your pathologist will assess sample adequacy
Step-by-Step Procedure
- Tumour tissue is collected during a biopsy (removal of a small amount of tissue) or surgery (removal of the entire tumour), typically in a hospital or surgical setting.
- The tissue sample is fixed in formalin and embedded in a paraffin wax block (the FFPE block) by the pathology laboratory, preserving it for molecular analysis.
- The FFPE block is transported to the Lupin Diagnostics laboratory at ambient temperature (18 to 28 degrees Celsius) in a secure box.
- DNA is extracted from the tumour tissue in the laboratory.
- The extracted DNA is analysed using Next Generation Sequencing (NGS) to detect mutations across all five markers.
- A detailed report is generated and delivered within 20 days.
Factors That Can Affect Accuracy
Several factors can influence the reliability of the test result:
- Low tumour cellularity (a low proportion of cancer cells in the tissue sample) can lead to false negatives
- Poor DNA quality caused by prior chemotherapy or radiation treatment
- Inadequate fixation of the tissue at the time of biopsy or surgery
- A mutation frequency below 2% in the tumour tissue, which may fall below the detection threshold
- Tumour heterogeneity, where different areas of the tumour carry different mutations
Understanding Your Solid Tumour Combo2 [MSI, NRAS, KRAS, BRAF, HRAS] Test Results
Results from this panel are qualitative, meaning each marker is reported as either wild-type (no mutation detected) or mutant (mutation detected, with the specific variant noted). Your oncologist will interpret these findings in the context of your cancer type, stage, and treatment history.
| Parameter | Possible Result | Interpretation |
|---|---|---|
| MSI Status | MSS (Stable), MSI-L (Low), MSI-H (High) | MSI-H: at least two of five markers show instability; MSI-L: one marker shows instability; MSS: no instability detected |
| KRAS | Wild-type or Mutant | Wild-type indicates no mutation; mutations may predict poor response to certain targeted drugs |
| NRAS | Wild-type or Mutant | Wild-type indicates no mutation; mutations affect suitability for specific treatments |
| BRAF | Wild-type or Mutant (V600E or other variants noted) | Wild-type indicates no mutation; V600E mutation may indicate eligibility for BRAF-targeted therapies |
| HRAS | Wild-type or Mutant | Wild-type indicates no mutation; mutations are associated with certain head and neck cancers |
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 situations can affect how results are generated or interpreted.
- Prior chemotherapy or radiation treatment may reduce DNA quality within the tumour tissue, which can affect the reliability of mutation detection.
- When a tissue sample contains very few tumour cells, the test may not detect mutations that are present, a situation known as a false negative.
- Tumour heterogeneity, where different sections of a tumour carry distinct genetic changes, may mean that results from one biopsy site do not reflect the full mutational profile of the cancer.
Post-Testing Guidance and Care
For patients undergoing cancer treatment or monitoring, the following general health practices are worth maintaining:
- Attend all scheduled cancer screenings and follow-up appointments recommended by your medical team
- Follow a balanced diet rich in dietary fibre and minimise processed foods where possible
- Report any new or worsening symptoms to your doctor promptly, without waiting for your next scheduled visit
Lupin Diagnostics Solid Tumour Combo2 [MSI, NRAS, KRAS, BRAF, HRAS] Test Price
The Solid tumour Combo2 test cost starts at ₹28,800 at Lupin Diagnostics. This test requires a visit to a Lupin Diagnostics centre and is performed on an FFPE tissue sample obtained through a biopsy or surgical procedure.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 28800 |
| CHENNAI | 28800 |
| HYDERABAD | 28800 |
| KOLKATA | 28800 |
| NAVI MUMBAI | 28800 |
| PUNE | 28800 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time or follow the instructions provided for submission of the FFPE tissue sample.
- Receive your report via email or WhatsApp within 20 days of sample submission.
Frequently Asked Questions
National oncology guidelines recommend testing for KRAS, NRAS, BRAF, and MSI status together in patients with metastatic colorectal cancer. Testing all five markers in a single panel is more time-efficient and cost-effective than running each test separately. Your oncologist can then make treatment decisions based on a complete genetic picture.
MSI-H status indicates that the tumour has a defect in its DNA repair system, which is associated with a high mutational burden. Tumours with MSI-H status have shown high response rates to immune checkpoint inhibitor therapies, and certain immunotherapy drugs have received regulatory approval specifically for MSI-H solid tumours. Your oncologist will advise on the most appropriate next steps.
The preferred sample for this Solid tumour Combo2 test is tumour tissue, as the research supporting mutation-based treatment decisions is based on tissue testing. Blood-based approaches (liquid biopsy) exist but are not the standard for this panel. The FFPE tissue block is required for a reliable result.
The report is delivered within 20 days from the date the sample is received by the laboratory. This timeframe reflects the complexity of NGS-based analysis. Your oncologist will review the findings with you once the report is available.
Clinical history is required to help the laboratory and reporting pathologist interpret the findings accurately. Details such as your cancer type, stage, prior treatments, and previous test results provide essential context for understanding the significance of any mutations detected.
Yes, the MSI component of this panel can flag tumours that are MSI-H, which may be associated with Lynch syndrome, a hereditary condition that significantly raises the risk of colorectal and several other cancers. If the result indicates MSI-H status, your doctor may recommend further germline genetic testing and counselling to determine whether an inherited mutation is present.
If a KRAS or NRAS mutation is found, certain targeted therapies, particularly anti-EGFR drugs, are unlikely to be effective and would typically not be recommended. Your oncologist will use this information to consider alternative treatment strategies best suited to your tumour's genetic profile.
Solid Tumour Combo2 [MSI, NRAS, KRAS, BRAF, HRAS] Test: Booking, Price, and Results
