Signature — The tests that feed a decision.
Comprehensive molecular profiling, from blood or tissue.
Signature is OnKommon's family of comprehensive molecular tests. Each one reads the DNA of your cancer — from a blood draw or a tissue block — and feeds the result into Blueprint Care, where it becomes a ranked, signed decision.
Signature is the test; Blueprint Care is the decision. Deliberately separate, always connected.
What every Signature test includes
Driver mutations, immune profile (TMB/MSI), pharmacogenomics (PGx), and tumour fraction — all baked in.
- Driver mutations: SNVs, InDels, fusions across the tier's gene set
- Immune profile: TMB, MSI and MMR on every tier
- PGx profile: 35-gene pharmacogenomics panel — how you metabolise drugs
- Tumour-fraction estimate: How much tumour DNA was present
- Flows into Blueprint Care: A ranked, signed decision
Choose the breadth that fits your situation.
Every Signature test feeds a Blueprint Care decision. The difference is how broad the molecular read is — and what it's read from.
| Tier | Sample | Breadth | Best for |
|---|---|---|---|
| Signature STb | Blood | 33 actionable genes + 13 fusions | Urgent, focused answers on directly-treatable drivers. |
| Signature STb O | Blood | 118 genes | A broad baseline — and the gateway to Sentinel monitoring. |
| Signature STb O+ | Blood | Comprehensive genomic profile (CGP) | The fullest liquid-biopsy picture, with a complete immune & PGx profile and trial matching. |
| Signature STt O | Tissue (FFPE) | Comprehensive genomic profile | When a tumour block is available and tissue is preferred. |
Self-contained. No confusing add-ons.
The markers your doctor needs to make a decision are baked into every tier.
Driver Mutations
SNVs & InDels across the tier's gene set, plus gene fusions and rearrangements for relevant targets.
Immune Profile
TMB, MSI and MMR — reported on every tier. On the 33-gene panel, an adhoc 200+ gene test provides these markers.
Pharmacogenomics (PGx)
The OnKommon Pharmacogenomics & Drug-Response Panel (35 genes) — how you may metabolise and react to key cancer drugs.
Copy-Number & Mutational Signatures
Included from the 118-gene tier upward, where panel breadth makes these analytically robust.
Tumour-Fraction Estimate
How much tumour DNA was present — so results are read in context.
TMB (Tumour Mutational Burden) counts how many mutations a tumour carries. A high count often means the immune system can recognise it — a signal that immunotherapy may help.
MSI (Microsatellite Instability) and MMR (Mismatch-Repair status) describe whether the tumour's DNA-proofreading machinery is broken. When it is (MSI-high / deficient MMR), the tumour accumulates mutations and frequently responds well to immunotherapy.
How every tier still gives you TMB and MSI: A focused 33-gene panel is too narrow to compute TMB on its own. So for the smaller panel we add a dedicated TMB and MSI assessment — an adhoc test run on a 200+ gene panel — which means every Signature tier reports TMB and MSI.
The OnKommon Pharmacogenomics & Drug-Response Panel
Beyond finding what drives the cancer, every Signature test reads how you are likely to handle the drugs used to treat it. Pharmacogenomics can prevent severe, even life-threatening, reactions and guide safe dosing — before the first dose.
Drug Metabolism & Response (25 genes)
DPYD, UGT1A1, TPMT, NUDT15, CYP2D6, CYP2C19, CYP3A5, CYP2B6, CYP2C9, VKORC1, ABCB1, ABCG2, SLCO1B1, SLC22A1, SLC22A2, CYP3A4, CYP1A2, GSTP1, GSTA1, GSTM1, GSTT1, TYMS, MTHFR, ENOSF1, CES2.
Drug Hypersensitivity — HLA (4 genes)
HLA-B57:01, HLA-B58:01, HLA-B15:02, HLA-A31:01
Advanced Pharmacogenomics — Antibody Response (2 genes)
FCGR2A, FCGR3A
DNA-Repair & Platinum Response (4 genes)
ERCC1, ERCC5, XRCC1, XRCC3
Why this is in every test, not sold separately. Pharmacogenomics is a safety net, and safety nets should never be optional. By baking the 35-gene panel into every Signature tier, we make sure your care team can dose the right drug safely — and steer clear of the ones most likely to harm you — as part of the same result that guides treatment choice.
How to choose.
Your consultation confirms which test fits your situation. Here is the decision framework.
If a recent FFPE block exists and tissue is preferred → Signature STt O
A blood draw avoids a surgical biopsy and can be faster → a Signature blood tier
Directly-actionable drivers, fast → STb (33)
Broad baseline + monitoring → STb O (118)
Fullest picture + full immune & PGx profile + trials → STb O+ (CGP)
A Signature test is the beginning, not the end.
Whichever tier you choose, its result flows into Blueprint Care — where the OnKommon Interpretation Engine and KPCIRC's molecular tumour board turn it into the decision and the plan. Every Signature purchase can be paired with the Blueprint Care relationship.
A molecular tumour board (MTB) is a panel of specialists — medical oncologists, pathologists, geneticists and scientists — who review a patient's molecular results together and agree the best evidence-based options. At OnKommon, KPCIRC's MTB authors and signs every Blueprint Care decision, so a qualified human team — not software — stands behind the report.
We are transparent about limits.
A negative result means the tested genes did not carry reportable changes — it does not mean cancer is absent, and it does not rule out alterations outside the panel. Liquid biopsies depend on tumour-DNA shedding. Occasionally, DNA changes in blood arise from normal ageing blood cells rather than the tumour (clonal haematopoiesis). Every report states these limits plainly, and a clinician interprets the result alongside your full clinical picture.
The science behind this
Signature uses liquid-biopsy and tissue comprehensive genomic profiling — an approach validated in large studies and recommended by international guidelines.
Study 1 · A blood-based CGP assay, extensively validated
A cfDNA-based comprehensive genomic profiling assay was clinically and analytically validated across more than 7,500 tests and over 30,000 variants, spanning 300+ genes and 30+ cancer types.
Study 2 · Guidelines support ctDNA profiling
Major guidelines (NCCN, ESMO) recommend ctDNA profiling as an alternative or complement to tissue, and ASCO recommends blood cfDNA as the specimen of choice for comprehensive profiling in advanced breast cancer.
Study 3 · Plasma genotyping finds more targets
Adding plasma ctDNA testing to tissue in advanced lung cancer increased the detection of targetable alterations and the number of patients who received matched therapy.
Need a second opinion or professional feedback? If you want an independent clinical view — or you are a clinician seeking a molecular tumour board discussion — our exclusive clinical partner KPCIRC provides paid second opinions, molecular tumour board reviews, and genetic counselling. Ask your navigator, or request it from any page.
The words you will see, in plain language.
What we DO
- Read the tumour's drivers, fusions, and immune & PGx profile
- Feed a ranked, MTB-signed Blueprint Care decision
- Report tumour fraction and per-gene coverage openly
- Suit blood or tissue, and repeat over time when needed
What we DON'T do
- Diagnose cancer or decide treatment on their own
- Rule out cancer from a "not detected" result
- Detect changes in genes outside the panel
- Guarantee a drug, its approval, cover, or that it will work
The Signature tests are genomic (DNA-based) tests offered for use by qualified healthcare professionals. They are intended to support — not replace — clinical judgement, and must be interpreted alongside your full clinical history, other investigations, and applicable guidelines.
- • A result is not a diagnosis and does not by itself decide treatment.
- • A "not detected" or normal result does not rule out cancer or a genetic change.
- • Not all cancers release enough DNA into blood to be detected.
- • The test does not guarantee access to any medicine, its regulatory approval, insurance cover, or that a therapy will work.
- • Sample-collection kits are for use by qualified phlebotomists only — not for self-testing or self-sampling.
- • Confirmatory testing may be required.
Regulatory status (India). OnKommon's registration of its genomic tests as in-vitro diagnostic (IVD) medical devices with the Central Drugs Standard Control Organisation (CDSCO) is in progress (IVD class pending). Sequencing and variant calling are performed by an accredited laboratory partner (College of American Pathologists — CAP-accredited; ISO 15189) following international guidelines (ACMG/AMP/ASCO/CAP) using a CE-IVD certified variant database. The OnKommon interpretation engine is provided for research and decision-support use. Marketing follows the Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954 and applicable Indian advertising standards.
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