PancNext

PancNext is a next generation sequencing panel that simultaneously analyzes 13 genes associated with increased risk for pancreatic cancer.

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Test Code 8042
Turnaround Time (TAT) 14-21 days
Number of Genes 13
Specimen Requirements Click here

Ordering Options

Why Is This Important?

  1. Option to modify frequency and initial age of cancer screening, as appropriate
  2. Consideration of risk-reducing measures, as appropriate 
  3. Option to tailor chemotherapy strategies and/or determine eligibility for clinical trials 
  4. Identify at-risk family members 

When To Consider Testing

  • Early-onset pancreatic cancer (diagnosed <60 years of age)
  • Multiple primary cancers in one person (e.g. pancreatic and colorectal or breast cancer)
  • 2 or more family members with pancreatic cancer*
  • 3 or more family members with pancreatic, breast, colorectal, uterine, ovarian, and/or melanoma*
  • Multiple close family members with pancreatic and other cancers*

* On the same side of the family

Mutation Detection Rate

PancNext can detect >99.9% of described mutations in the included genes listed above, when present (analytic sensitivity).

Test Description

PancNext analyzes 13 genes (listed above). Twelve genes (excluding EPCAM) are evaluated by next generation sequencing (NGS) or Sanger sequencing of all coding domains, and well into the flanking 5’ and 3’ ends of all the introns and untranslated regions. In addition, sequencing of the promoter region is performed for the following genes: PTEN (c.-1300 to c.-745), MLH1 (c.-337 to c.-194), and MSH2 (c.-318 to c.-65). The inversion of coding exons 1-7 of the MSH2 gene and the BRCA2 Portuguese founder mutation, c.156_157insAlu (also known as 384insAlu) are detected by NGS and confirmed by PCR and agarose gel electrophoresis. Clinically significant intronic findings beyond 5 base pairs are always reported. Intronic variants of unknown or unlikely clinical significance are not reported beyond 5 base pairs from the splice junction. Additional Sanger sequencing is performed for any regions missing or with insufficient read depth coverage for reliable heterozygous variant detection. Reportable small insertions and deletions, potentially homozygous variants, variants in regions complicated by pseudogene interference, and single nucleotide variant calls not satisfying 100x depth of coverage and 40% het ratio thresholds are verified by Sanger sequencing. Gross deletion/duplication analysis is performed for the covered exons and untranslated regions of all 13 genes using read-depth from NGS data with confirmatory multiplex ligation-dependent probe amplification (MLPA) and/or targeted chromosomal microarray. For APC, all promoter 1B gross deletions as well as single nucleotide substitutions within the promoter 1B YY1 binding motif are analyzed and reported. If a deletion is detected in exons 13, 14, or 15 of PMS2, double stranded sequencing of the appropriate exon(s) of the pseudogene, PMS2CL, will be performed to determine if the deletion is located in the PMS2 gene or pseudogene.

 

1. Mu W, et al. Sanger confirmation is required to achieve optimal sensitivity and specificity in next-generation sequencing panel testing. J Mol Diagn. 2016. 18(6):923-932.

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