02 · Four testing pathways
Solid tumours · Liquid 523
Twin Liquid. Plasma-based ctDNA analysis for the solid-tumour pathway.
Overview
What this pathway is
OnKommon Twin · Twin Liquid
523-gene ctDNA panel from plasma. Hereditary testing included for germline filtering.
Tumours release small fragments of their DNA into the bloodstream, known as circulating tumour DNA (ctDNA). Twin Liquid analyses ctDNA from plasma using a 523-gene panel. Because it needs a blood sample rather than tissue, it can be useful when tissue is limited or difficult to obtain.
Intended audience and use
Who it is for
People with solid tumours for whom the treating team wants plasma-based testing — when tissue is limited, or for repeated reads over time.
Sample and testing pathway
Sample and what is generated
- Sample
- Plasma.
- Information generated
- Findings across the 523-gene panel. Hereditary testing is included, so inherited variants are filtered out before tumour findings are interpreted.
From result to Twin
How the information enters Twin
ctDNA findings feed the baseline Twin. SourceGuard is particularly relevant here, because plasma can contain inherited variants and variants from ageing blood cells as well as tumour DNA.
Analytical layers most relevant to this route
Strengths
Why this route
- A blood draw instead of a biopsy.
- DNA shed from across the tumour — not one biopsy site.
- Hereditary testing built in, and SourceGuard separates tumour DNA from clonal haematopoiesis.
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