Illustrative composite
Meenakshi Podwal
52, Pune. Newly diagnosed.
Newly diagnosed, reports arriving faster than they can be read
“There were three reports and two appointments in one week. I did not know which of it mattered, or what I was supposed to be deciding.”
What was already established
- A histological diagnosis of lung adenocarcinoma
- Staging imaging showing metastatic disease
- A small diagnostic biopsy, most of it already used
- No molecular result yet, and treatment due to start
- 01
First contact
Signal
A question sent on WhatsApp on a Sunday evening: is genomic testing something we should be asking about, or is that for later? A reply within four hours explained that in advanced non-squamous lung cancer this is usually a question for now rather than later, because a driver alteration can change the first treatment rather than the second.
- 02
Free consultation
Blueprint consultation
The care team went through what had already been done. The important finding was not clinical: the biopsy was small and largely spent, which is the most common reason profiling fails in this cancer.
- 03
Testing
Signature STb O, from blood
Because tissue was limited, plasma was used in parallel rather than after a failed tissue attempt. The panel was chosen to read fusions as well as point mutations, since several lung drivers are structural.
- 04
Decision
Blueprint Care, signed by KPCIRC
A ranked report with the evidence tier for each option, explicit contraindications, matched recruiting trials, and biosimilar and assistance mapping. Reviewed and signed by the molecular tumour board.
- 05
Afterwards
A named navigator
One person to call, who chased the pathology, filed the assistance paperwork, and sat with the family when the report was explained.
What we actually did
Planned
A ranked Blueprint Care decision with an evidence tier against every option, contraindications named, and the reasoning written out. It reached her oncologist before the first cycle was prescribed rather than after it had started.
Matched
The driver alteration matched to a licensed targeted therapy, and separately to two recruiting trials checked against her staging, her prior treatment and how far she could reasonably travel.
Access
Biosimilar and assistance mapping run against the matched therapy, the manufacturer assistance application completed and filed by her navigator, and the hospital pathology team chased directly so the block never had to be re-requested.
What changed
The result arrived before the first treatment decision rather than after it, which is the single thing that most often does not happen.
What it did not do
It did not make the diagnosis, choose the treatment, or promise that any option would work. Her treating oncologist made every clinical decision. Profiling narrows and evidences the options; it does not pick one.