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Somatic Genomic Testing for Metastatic or Advanced Cancer

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106 Commerce Street, Suite 105 Lake Mary, FL 32746 TEL: 407.878.7606 • FAX: 407.878.7611 Order additional copies at GuidelineCentral.com Copyright © 2022 All rights reserved ASCOGEN02223a ASCO believes that cancer clinical trials are vital to inform medical decisions and improve cancer care and that all patients should have the opportunity to participate. Additional information, which may include data supplements, slide sets, and other clinical tools and resources, is available at www.asco.org/assays-and-predictive-markers-guidelines. Disclaimer is pocket guide is derived om recommendations in the American Society of Clinical Oncolog y Guideline. is resource is a practice tool based on ASCO ® practice guidelines and is not intended to substitute for the independent professional judgment of the treating physician. Practice guidelines do not account for individual variation among patients. is pocket guide does not purport to suggest any particular course of medical treatment. Use of the practice guidelines and this resource are voluntary. e practice guidelines and additional information are available at www.asco.org/ assays-and-predictive-markers-guidelines. Copyright © 2022 by American Society of Clinical Oncolog y. All rights reserved. Source Chakravarty D, Johnson A, Sklar J, et al. Somatic Genomic Testing in Patients with Metastatic or Advanced Cancer: ASCO Provisional Clinical Opinion. J Clin Oncol. 2022 Feb 17. doi:10.1200/JCO.21.02767. Abbreviations ATM, ataxia telangiectasia mutated gene; cf DNA, circulating free DNA; CNV, copy number variation; ctDNA, circulating tumor; CUP, cancers of unknown primary; dMMR, mismatch repair deficiency; DNA, deoxyribonucleic acid; FDA, Food and Drug Administration; GIS, genomic instability score; HGVS, Human Genome Variation Society; HRD, homologous recombination deficiency; ITH, intratumoral heterogeneity; LOH, loss of heterozygosity; LST, large-scale state transitions; MRD, minimal residual disease; MSI, microsatellite instability; MSI-H, microsatellite instability-high; NGS, next- generation sequencing ; NSCLC, non-small cell lung cancer; NTRK, neurotrophic tyrosine receptor kinase; PARP, poly-ADP ribose polymerase; PCO, provisional clinical opinion; P/LP, pathogenic or likely pathogenic; RNA, ribonucleic acid; SEGA, subependymal giant-cell astrocytomas; TAI, telomeric allelic imbalance; TMB, tumor mutation burden; TMB-H, tumor mutational burden-high; TRK, tyrosine receptor kinase; VAF, variant allele fraction

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