02 · Four testing pathways
Solid tumours · Exome / WES
Twin Exome. A whole-exome route for solid-tumour analysis.
Overview
What this pathway is
OnKommon Twin · Twin Exome
Whole-exome sequencing (WES) across every protein-coding gene.
Twin Exome uses whole-exome sequencing (WES), which reads the protein-coding regions of the genome — roughly 1–2% of the DNA, where many known cancer-relevant changes occur.
Intended audience and use
Who it is for
People with solid tumours whose treating team wants the broadest molecular view of the tumour.
Sample and testing pathway
Sample and what is generated
- Sample
- Tumour tissue — FFPE or fresh.
- Information generated
- Integrated analytical features — SNVs and indels, CNVs, gene fusions, TMB, MSI, HRD, HLA typing and pharmacogenomics — across every protein-coding gene.
From result to Twin
How the information enters Twin
Exome-scale data give the analytical layers the most to work with: CloneTrace and SigPrint in particular depend on having enough mutations. Findings then pass through evidence layers such as AccessMatch, ResistMap and TrialGraph and are placed in clinical context.
Analytical layers most relevant to this route
- 1CloneTraceClonality and tumour evolution
- 2SourceGuardSomatic and germline interpretation
- 3SigPrintMutational signatures and aetiology
- 4PhenoMapMolecular and cellular phenotype
- 5ImmuneLensImmune landscape and biomarkers
- 6AccessMatchActionable alterations and targetability
- 8ResistMapResistance mechanisms and bypass routes
- 16TrialGraphClinical trial matching and prioritisation
Strengths
Why this route
- The broadest view: every protein-coding gene, not a preselected list.
- Enough mutations for CloneTrace and SigPrint to reconstruct the tumour's history and signatures.
- The same exome powers OnKommon AVATAR when a biological investigational plan is needed.
How every finding is interpreted, from detection to decision
Deliverables
What you receive
- A structured Twin report in the five documented components: executive molecular summary, molecular findings, treatment options to evaluate, clinical-trial matches and a longitudinal view.
- Review and sign-off by the treating oncologist, within the KPCIRC sign-off process.
- Entry into the six-month Twin journey, with the option to continue into a Twin track afterwards.
The treating oncologist owns every decision. Every Twin report is reviewed and signed by the treating oncologist, then taken to KPCIRC's Molecular Tumour Board.
KPCIRC sign-off processQuestions