Overview

What is GPS Cancer™?

GPS Cancer is a unique comprehensive test available through NantHealth. GPS Cancer integrates whole genome (DNA) sequencing, whole transcriptome (RNA) sequencing and quantitative proteomics, resulting in a comprehensive molecular profile of a patient’s cancer to inform personalized treatment strategies.

How does GPS Cancer help physicians and their patients?

By providing insight into the unique biology of the patient's tumor, GPS Cancer allows physicians to identify potential treatment options, including approved drugs and active clinical trials that correspond to the molecular composition of a patient’s individualized tumor.

Is GPS Cancer available for all cancer types?

Currently we offer GPS Cancer for solid tumors.

Why does GPS Cancer include quantitative proteomics?  

Most cancer therapies target proteins or require proteins to be effective. Knowing how much of a specific protein is present in a tumor can help to better understand which cancer therapies may be effective or may be ineffective against the tumor.

What types of genomic alterations are identified by GPS Cancer?

GPS Cancer identifies single nucleotide variants (alterations that affect single nucleotides), insertions and deletions (insertions or deletions of a number of nucleotides), copy number variants (number of copies of a gene), and translocations (rearrangement of chromosomes) from whole genome sequence data obtained from tumor samples.

How does GPS Cancer lead to clinically relevant insights?

Whole genome sequencing of a patient’s tumor sample and normal sample is performed to pinpoint genomic alterations that are specific to the tumor. RNA sequencing confirms genomic alterations that may result in the expression of abnormal proteins – abnormal proteins are important targets for many cancer therapies. Quantitative proteomics measures the amounts of clinically relevant proteins, and knowing how much of a specific protein is present can help oncology care providers understand potential responses to different cancer therapies, including chemotherapies, targeted therapies and immunotherapies.  

How is GPS Cancer different from other tests?

GPS Cancer analyzes the entire tumor genome rather than focusing on select genes or regions of the genome.  This broad survey of the genome can identify a wide range of genetic alterations that may drive the cancer, thereby providing a better understanding of the molecular pathogenesis of the tumor, and potentially identifying a broader set of possible therapeutic targets. In addition, GPS Cancer analyzes RNA alterations and quantitates clinically relevant proteins that are associated with response to targeted therapy, response to chemotherapy, or resistance to chemotherapy. Knowing whether specific protein targets are encoded in the genetic material of a tumor as well as the amount of each protein target in a tumor can help to predict the effectiveness of cancer therapies.


Results

What information is provided in the GPS Cancer Report?

The report may list FDA-approved cancer therapies with potential for clinical benefit (if any are available), active clinical trials of therapies with potential for clinical benefit, and/or available therapies to which the cancer may be resistant. The GPS Cancer report does not recommend treatments, and it is the responsibility of the treating physician to develop a personalized treatment plan after discussing the available treatment options and the potential risks associated with each option with the patient.

Will GPS Cancer always lead to treatment options for patients?

Healthcare professionals should make patients aware that GPS Cancer may not provide any options for therapy if no approved or investigational agents and no clinical trials exist for a particular tumor alteration. In these instances, patients may still be eligible to receive standard treatments, such as chemotherapy and radiation therapy, for their cancer. In addition, patients with certain other medical conditions may not qualify for treatment with the options listed by GPS Cancer, despite the presence of tumor genomic alterations.

How are the GPS Cancer results reported?

A GPS Cancer Report listing identified genomic alterations, estimates of pathogenicity of these alterations, amounts of clinically relevant proteins, and potential treatment options (if available) based on these findings is generated and is sent directly to the ordering physician. A number of tumor alterations can be matched to cancer therapies, and the report may list FDA-approved cancer therapies with potential for clinical benefit for the physician’s consideration. The report may also direct physicians and patients to active clinical trials of cancer therapies with potential for clinical benefit as well as available cancer therapies to which the cancer may be resistant.

Does GPS Cancer recommend a treatment plan?

The GPS Cancer Report does not recommend a treatment plan, but rather it lists potential treatment options, if any. It is the responsibility of the patient’s physician to develop a personalized treatment plan after discussing any available treatment options with the patient.

How long does it take to receive the GPS Cancer results?

The testing typically takes three weeks from the time the tissue and blood samples are received to the time the physician receives the report.

If I have questions about my patient’s test results, whom should I contact?

Physicians can contact the GPS Care Center, and physician peer-to-peer consultation time will be scheduled.

Can my patient make an appointment to discuss GPS Cancer results?

If a patient has questions after speaking with you about the results, they can reach out to the GPS Care Center, and a staff member will schedule a time to meet with a representative from the NantHealth Medical Affairs Team. The GPS Care Center does not provide medical care.

How does my patient or another physician request a copy of the report?

Written requests can be directed to the GPS Care Center.


Specimens

Does the age of the tumor sample affect the results of the test?

Alterations within a tumor can change over time. It is preferable to perform GPS Cancer on the patient’s most recent biopsy so that healthcare providers can develop the most accurate treatment plan for their patients.

Why is a blood sample required for the GPS Cancer test?

A blood sample is required to compare the tumor DNA with the normal DNA present in the patient’s blood sample.

How are patient samples submitted?

After the Test Requisition Form and Patient Informed Consent Form are submitted, a tumor collection kit will be sent to the pathology laboratory holding the patient’s tissue sample, and a blood collection kit will be sent to the ordering physician or preferred laboratory to collect the patient’s blood sample. Both sample kits should be mailed directly to the laboratory for testing.

What are the specimen requirements for GPS Cancer?

For information on specimen requirements, please visit the Specimen Requirements page.

Are my patient’s medical records or prior test results needed?

No additional medical records or test results are needed.

If there is a delay receiving the tissue sample, who will resolve the issue?

We work very closely with pathology departments to avoid any delays. And we will contact the pathology department directly to address any issues unless otherwise indicated by the physician.


Cost

How much does the GPS Cancer test cost?

Please contact the GPS Care Center to discuss cost and insurance coverage.

Will GPS Cancer be reimbursed?

For reimbursement information please visit the Reimbursement page.


Secondary Germline Screening

What is secondary germline screening? 

The DNA and/or RNA sequence data generated during molecular analysis of cancer can also be evaluated for secondary findings that may have medical utility for you and your patient. Performed in addition to the principal testing of the cancer specimen, this secondary analysis offered by NantHealth looks for genetic variants that are present not only in cancer cells, but also in noncancerous cells within the body. These more widely distributed genetic abnormalities are referred to as germline abnormalities since they are likely to be present in reproductive tissue often referred to as the germline. Secondary screening is optional, and patients will have the opportunity to opt in or opt out while completing the NantHealth Patient Informed Consent. 

What genes are evaluated in the secondary germline screening? 

NantHealth offers secondary screening for a select set of cancer predisposition genes. This list includes a number of genes that are recommended by the American College of Medical Genetics (ACMG) and are compatible with our genetic analytic processes. 

What is the clinical significance of secondary findings?

The presence of germline genetic abnormalities in cancer predisposition genes can lead to an increased risk of particular types of cancers and other medical conditions. Knowing that an individual has a germline abnormality in a cancer predisposition gene could be beneficial as screening for future cancers and/or specialized therapies may be available. Since these types of abnormalities can be inherited, there also is a chance that other family members related by blood could also carry these genetic abnormalities. The results of secondary screening performed by NantHealth should be discussed with the physician, who may recommend consultation with a medical geneticist. (At this time, NantHealth does not provide genetic counseling.)

What are the limitations of the secondary germline screening?

The testing procedure employed for this screening only looks for a very specific class of genetic abnormalities that are predicted to disrupt the function of these genes. This screening test does not comprehensively evaluate these genes for all types of alterations that may have clinical consequences, thus there could be additional genetic abnormalities in any of the genes regardless of the test result. Furthermore, not all genes that increase the risk of cancer are included in this test. 

What does secondary screening cost? 

The test is run at no additional cost.

How should a patient decide whether to opt in to secondary germline screening?

If a patient has questions about whether to opt in or out for secondary germline screening, the patient should discuss with his or her physician.  

How does a patient opt in to secondary screening, and how do they receive the results? 

Patients have the opportunity to opt in/out of secondary germline testing while completing the NantHealth Patient Informed Consent. If the patient indicates that s/he wishes to have this test performed, the test will be performed in parallel with the other genomic testing of your cancer and normal tissue samples, and the results will be included in the clinical report containing the cancer genomics test results. This test will not affect the time required to generate the clinical report. 


International Samples

Are international samples accepted?

For information on submitting samples from outside the US please contact the GPS Care Center.