Test Catalog

Test Id : MELP

Melanoma Targeted Gene Panel, Next-Generation Sequencing, Tumor

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosis and management of patients with melanoma

 

Simultaneously interrogating multiple gene targets including BRAF (eg, V600E and V600K), GNAQ, GNA11, KIT and NRAS

Genetics Test Information
Provides information that may help with selection of the correct genetic test or proper submission of the test request

This test uses targeted next-generation sequencing to evaluate for somatic mutations within the BRAF (exons 11 and 15), GNAQ (exon 5), GNA11 (exon 5), KIT (exon 2, 9, 10, 11, 13, 14, 15, 17, 18), and NRAS (exons 2, 3, 4) genes. This includes, but is not limited to, the testing of somatic mutations in NRAS codons 12, 13, 61,146; GNA11 and GNAQ codon 209; and BRAF codons 594, 596, 600 (e.g. V600E/K). See Targeted Gene Regions Interrogated by Melanoma Panel in Special Instructions for details regarding the targeted gene regions identified by this test.

Additional Tests
Lists tests that are always performed, at an additional charge, with the initial tests.

Test Id Reporting Name Available Separately Always Performed
SLIRV Slide Review in MG No Yes

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

When this test is ordered, slide review will always be performed at an additional charge.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Name
A short description of the method used to perform the test

Polymerase Chain Reaction (PCR)-Based Next Generation Sequencing

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Melanoma Panel, Tumor

Aliases
Lists additional common names for a test, as an aid in searching

Melanoma

Mutation Screening

GST11

GST13

GST17

Oncology panel

Tumor panel

BRAF

GNA11

GNAQ

KIT

NRAS

Next Gen Sequencing Test

NGS

BRAF V600

BRAF V600E

BRAF V600K

V600

V600K

V600E

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

When this test is ordered, slide review will always be performed at an additional charge.

Specimen Type
Describes the specimen type validated for testing

Varies

Ordering Guidance

Mutations in genes interrogated by this test can be seen in neoplasms other than melanoma. For KIT Asp816Val mutation analysis in mast cell disease, see KITAS / KIT Asp816Val Mutation Analysis, Qualitative PCR, Varies.

 

Multiple oncology (cancer) gene panels are available. For more information see Oncology Somatic NGS Testing Guide.

Necessary Information

Pathology report (final or preliminary) at minimum containing the following information must accompany specimen in order for testing to be performed:

1. Patient name

2. Block number-must be on all blocks, slides and paperwork (can be handwritten on the paperwork)

3. Tissue collection date

4. Source of the tissue

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

This assay requires at least 20% tumor nuclei.

-Preferred amount of tumor area with sufficient percent tumor nuclei: tissue144 mm(2)

-Minimum amount of tumor area: tissue 36 mm(2).

-These amounts are cumulative over up to 10 unstained slides and must have adequate percent tumor nuclei.

-Tissue fixation: 10% neutral buffered formalin, not decalcified

-For specimen preparation guidance, see Tissue Requirement for Solid Tumor Next-Generation Sequencing in Special Instructions. In this document, the sizes are given as 4mm x 4mm x 10 slides as preferred: approximate/equivalent to 144 mm(2) and the minimum as 3mm x 1mm x 10 slides: approximate/equivalent to 36mm(2).

Preferred:

Specimen Type: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded tissue block with acceptable amount of tumor tissue.

 

Acceptable:

Specimen Type: Tissue slide

Slides: 1 stained and 10 unstained

Collection Instructions: Submit 1 slide stained with hematoxylin and eosin and 10 unstained, nonbaked slides with 5-micron thick sections of the tumor tissue.

Note: The total amount of required tumor nuclei can be obtained by scraping up to 10 slides from the same block.

Specimen Type: Cytology slide (direct smears or ThinPrep)

Slides: 1 to 3 slides

Collection Instructions: Submit 1 to 3 slides stained and cover slipped with a preferred total of 5000 nucleated cells or a minimum of at least 3000 nucleated cells.

Note: Glass coverslips are preferred; plastic coverslips are acceptable but will result in longer turnaround times.

Additional Information: Cytology slides will not be returned.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Forms

If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

See Specimen Required

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Other Specimens that have been decalcified (all methods) Specimens that have not been formalin-fixed, paraffin-embedded

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Varies Ambient (preferred)
Frozen
Refrigerated

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosis and management of patients with melanoma

 

Simultaneously interrogating multiple gene targets including BRAF (eg, V600E and V600K), GNAQ, GNA11, KIT and NRAS

Genetics Test Information
Provides information that may help with selection of the correct genetic test or proper submission of the test request

This test uses targeted next-generation sequencing to evaluate for somatic mutations within the BRAF (exons 11 and 15), GNAQ (exon 5), GNA11 (exon 5), KIT (exon 2, 9, 10, 11, 13, 14, 15, 17, 18), and NRAS (exons 2, 3, 4) genes. This includes, but is not limited to, the testing of somatic mutations in NRAS codons 12, 13, 61,146; GNA11 and GNAQ codon 209; and BRAF codons 594, 596, 600 (e.g. V600E/K). See Targeted Gene Regions Interrogated by Melanoma Panel in Special Instructions for details regarding the targeted gene regions identified by this test.

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

When this test is ordered, slide review will always be performed at an additional charge.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Targeted cancer therapies are defined as antibody or small molecule drugs that block the growth and spread of cancer by interfering with specific cell molecules involved in tumor growth and progression. Multiple targeted therapies have been approved by the FDA for treatment of specific cancers. Molecular genetic profiling is often needed to identify targets amenable to targeted therapies and to minimize treatment costs and therapy-associated risks.

 

Next generation sequencing has recently emerged as an accurate, cost-effective method to identify mutations across numerous genes known to be associated with response or resistance to specific targeted therapies. This test is a single assay that uses formalin-fixed paraffin-embedded tissue to assess for common mutations in the following genes known to be associated with melanoma: BRAF, GNA11, GNAQ, KIT, and NRAS. This includes the common BRAF V600E and V600K mutations. The results of this test can be useful for assessing prognosis and guiding treatment of individuals with melanoma.

 

See Targeted Gene Regions Interrogated by Melanoma Panel in Special Instructions for details regarding the targeted gene regions identified by this test.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

An interpretative report will be provided.

Interpretation
Provides information to assist in interpretation of the test results

An interpretive report will be provided.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

This test cannot differentiate between somatic and germline alterations. Additional testing may be necessary to clarify the significance of results if there is a potential hereditary risk. DNA variants of uncertain significance may be identified.

 

A negative (wild-type) result does not rule out the presence of a mutation that may be present but below the limits of detection of this assay (approximately 5%-10%). This test does not detect large single or multiexon deletions or duplications or genomic copy number variants.

 

Rare polymorphisms may be present that could lead to false-negative or false-positive results. Test results should be interpreted in the context of clinical findings, tumor sampling and other laboratory data. If results obtained do not match other clinical or laboratory findings, contact the laboratory for updated interpretation. Misinterpretation of results may occur if the information provided is inaccurate or incomplete.

 

Reliable results are dependent on adequate specimen collection and processing. This test has been validated on formalin-fixed, paraffin-embedded tissues; other types of fixatives are discouraged. Improper treatment of tissues, such as decalcification, may cause PCR failure.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Carvajal RD, Antonescu CR, Wolchok JD, et al: KIT as a therapeutic target in metastatic melanoma. JAMA 2011;305(22):2327-23342. Postow MA, Carvajal RD: Therapeutic implications of KIT in melanoma. Cancer J 2012;2:137-141

3. Johnson DB, Sosman JA: Update on the targeted therapy of melanoma. Curr Treat Options Oncol 2013;2:280-292

4. Anderson S, Bloom K, Vallera D, et al: Multisite analytic performance studies of a real-time polymerase chain reaction assay for the detection of BRAF V600E mutations in formalin-fixed paraffin-embedded tissue specimens of malignant melanoma. Arch Pathol Lab Med 2012 Nov;136(11):1385-1391

5. Chapman P, Hauschild A, Robert C, et al: BRIM-3 Study Group. Improved survival with vemurafenib in melanoma with BRAF V600E mutation. N Engl J Med 2011 Jun 30;364(26):2507-2516

6. Dhomen N, Marais R: BRAF signaling and targeted therapies in melanoma. Hematol Oncol Clin North Am 2009 Jun;23(3):529-545

7. Flaherty K, Puzanov I, Kim K, et al: Inhibition of mutated, activated BRAF in metastatic melanoma. N Engl J Med 2010 Aug 26;363(9):809-819

8. Ascierto P, Schadendorf D, Berking C, et al: MEK162 for patients with advanced melanoma harbouring NRAS or Val600 BRAF mutations: a non-randomised, open-label phase 2 study. Lancet Oncol 2013 Mar;14(3):249-256

9. Jakob J, Bassett R, Ng C, et al: NRAS Mutation status is an independent prognostic factor in metastatic melanoma. Cancer 2012 Aug 15;118(16):4014-4023

10. Van Raamsdonk C, Griewank K, Crosby M, et al: Mutations in GNA11 in uveal melanoma. N Engl J Med 2010 Dec 2;363(23):2191-2199

11. Kusters-Vandevelde H, Klaasen A, Kusters B, et al: Activating mutations of the GNAQ gene: a frequent event in primary melanocytic neoplasms of the central nervous system. Acta Neuropathol 2010 Mar;119(3):317-323

12. Griewank K, van de Nes J, Schilling B, et al: Genetic and clinico-pathologic analysis of metastatic uveal melanoma. Mod Pathol 2014 Feb;27(2):175-183

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Description
Describes how the test is performed and provides a method-specific reference

Next generation sequencing is performed to test for the presence of a mutation in targeted regions of the BRAF, GNA11, GNAQ, KIT, and NRAS genes. See Targeted Gene Regions Interrogated by Melanoma Panel in Special Instructions for details regarding the targeted gene regions identified by this test.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

12 to 20 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

Unused portions of blocks will be returned. Unused slides are stored indefinitely.

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

81445 

88381-Microdissection, manual

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
MELP Melanoma Panel, Tumor In Process
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
54879 Result Summary 50397-9
54880 Result 82939-0
54881 Interpretation 69047-9
54882 Additional Information 48767-8
54884 Specimen 31208-2
54885 Source 31208-2
54886 Tissue ID 80398-1
54887 Released By 18771-6

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports