Hereditary Tumor Syndromes

Analysis of all known genes associated with hereditary tumor syndromes

Germline genetic testing examines cancer predispositions and enables early treatment. Every fifth tumor develops due to a hereditary predisposition. Prevention is the most important measure in the fight against tumor diseases. Knowing predispositions and initiating appropriate early-detection examinations are central components in preventing metastatic and late-detected disease progression. Genetic tumor diagnosis is especially important for persons with a family history of cancer as it assesses their risk of developing cancer.

The Diagnostic Panel for Hereditary Tumor Diseases is based on exome sequencing with CeGaT’s ExomeXtra®. CeGaT’s ExomeXtra® covers all protein-coding regions as well as all known pathogenic intronic and intergenic variants. It thus provides the best basis for genetic diagnostics.

Are you insured in Germany? Our colleagues at the Zentrum für Humangenetik Tübingen will gladly support you!

What We Offer with the Panel for Hereditary Tumor Syndromes

Updates

The gene selection is regularly adapted to the current scientific knowledge

Flexibility

With ExomeXtra®, gene sets addressing different diseases can be combined

Comprehensive Medical Report

Including the ACMG criteria used to classify the variants

Highest Quality

All steps are carried out in-house

Our Promise to You

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Fast Turnaround Time

2–4 weeks after sample receipt

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Safety

Highest confidentiality and quality standards

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Reliability

Reliable support throughout all steps

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Comprehensibility

Clearly prepared medical report

Your Benefits

It is possible to request single or multiple predefined gene sets. In addition to the complete analysis of the genes of the requested gene set, we extend the analysis by additional genes for differential diagnosis. We report variants of unknown significance (ACMG class 3) and pathogenic and probably pathogenic variants (ACMG classes 4 and 5) for the primarily ordered gene set. For the genes included due to differential diagnosis, we restrict the reporting to pathogenic and probably pathogenic variants (ACMG classes 4 and 5), which could be related to the indication of the person seeking advice.

The Diagnostic Panel for Hereditary Tumor Syndromes is based on CeGaT’s ExomeXtra® enrichment. This allows, without additional sequencing, phenotypically eligible gene sets of other CeGaT panels or single genes to be additionally ordered. If you would like to assemble an individual panel, please feel free to contact us. We will be happy to support you.

In addition to the primary diagnostic assignment, the assessment of ACMG genes and pharmacogenetic profiling may also be ordered.

Method

The enrichment of the coding regions and the adjacent intronic regions is performed using an in-solution hybridization technology. The selection of the targeted regions and the design of the enrichment baits is performed in-house. High-throughput sequencing is performed on our Illumina platforms. Bioinformatic processing of the data is achieved using an in-house computer cluster.

Following data processing, our team of scientists and specialists in human genetics analyze the data and issue a medical report.

Sample Report

General Information

Material

  • 1–2 ml EDTA blood (recommended sample type) or
  • 1–2 µg genomic DNA
  • Order Form with declaration of consent

Here you can find more information on how to ship your sample safely.

Costs

The prices for our human genetic diagnostics depend on the size of the selected diagnostic panel and the selected gene sets. All prices include sequencing, bioinformatic analysis, and issuing of a medical report by our team of experts in human genetic diagnostics.

Diagnostic Process

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Counseling & Test Selection

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Sampling & Shipment

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Sample Analysis

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Medical Report & Counseling

Colorectal Cancer

Colorectal Cancer (CAN01, 26 Genes)

APC, ATM, AXIN2, BMPR1A, BRIP1, CDH1, CHEK2, GREM1, MBD4, MLH1, MSH2 (inkl. relevanter Elemente im 3‘-Bereich von EPCAM), MSH3, MSH6, MUTYH, NF1, NTHL1, PMS2, POLD1, POLE, PTEN, RNF43, RPS20, SCG5, SMAD4, STK11, TP53

Optional MLPA Set
MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, PMS2

Polyposis Syndromes (CAN11, 15 Genes)

APC, BMPR1A, GREM1, MBD4, MSH3, MUTYH, NF1, NTHL1, POLD1, POLE, PTEN, RNF43, SCG5, SMAD4, STK11

Lynch Syndrome/Hereditary Nonpolyposis Colorectal Cancer (HNPCC) (CAN12, 4 Genes)

MLH1, MSH2 (incl. 3‘ region of EPCAM), MSH6, PMS2

Optional MLPA Set
MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, PMS2

MLH1 Promoter Methylation

Gynecologic Cancer

Gynecologic Cancer (Breast Cancer, Ovarian Cancer, Fallopian Tube Cancer) (CAN02, 15 Genes)

ATM, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, NF1, PALB2, POLD1, PTEN, RAD51C, RAD51D, STK11, TP53

Optional MLPA Set
BRCA1, BRCA2

Gynecologic Cancer – Extended Diagnostics (Optional After/ Together with CAN02; Including Candidate Genes) (CAN21, 25 Genes)

No detection of a pathogenic or likely pathogenic variant in 15 core genes.

ABRAXAS1, BAP1, BLM, CDC73, DICER1, FANCA, FANCB, FANCC, FANCD2, FANCE, FANCF, FANCG, FANCI, FANCL, FANCM, MRE11, MUTYH, NBN, POLE, RAD50, RECQL4, RINT1, SLX4, SMARCA4, TGFBR1

Endometrial Carcinoma (CAN24, 11 Genes)

BRCA1, BRCA2, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, MUTYH, NTHL1, PMS2, POLE, POLD1, PTEN

Gastrointestinal Neoplasia

Gastric Cancer (CAN13, 15 Genes)

APC, ATM, BRCA2, CDH1, CHEK2, CTNNA1, KIT, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, PDGFRA, PMS2, SMAD4, SKT11, TP53

Optional MLPA Set
BRCA2, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, PMS2

Gastrointestinal Stromal Tumor (GIST) (CAN15, 7 Genes)

KIT, NF1, PDGFRA, SDHA, SDHB, SDHC, SDHD

Gastroenteropancreatic Neuroendocrine Neoplasia (CAN16, 10 Genes)

CDKN1A, CDKN1B, CDKN2B, CDKN2C, MEN1, NF1, RET, TSC1, TSC2, VHL

Endocrine Tumors

Pheochromocytoma and Paraganglioma (CAN04, 17 Genes)

CDKN1B, DLST, EGLN1, FH, KIF1B, MAX, MDH2, MEN1, NF1, RET, SDHA, SDHAF2, SDHB, SDHC, SDHD, TMEM127, VHL

Thyroid Neoplasia (CAN17, 13 Genes)

APC, ATM, CDC73, CDKN1B, CDKN2C, CHEK2, DICER1, MEN1, PTEN, RET, SDHB, SDHC, TP53

Isolated Familial Pituitary Adenoma (CAN23, 3 Genes)

AIP, CDKN1B, MEN1

Pancreatic Cancer

Pancreatic Cancer (CAN06, 13 Genes)

APC, ATM, BRCA1, BRCA2, CDKN2A, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, PALB2, PMS2, STK11, TP53, VHL

Optional MLPA Set
BRCA1, BRCA2, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, PMS2

Tumors of the Central Nervous System

Tumors of the Central Nervous System (CAN51, 22 Genes)

APC, DICER1, ELP1, LZTR1, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, MUTYH, NF1, NF2, PMS2, POT1, PTCH1, PTEN, SMARCA4, SMARCB1, SMARCE1, SUFU, TP53, TSC1, TSC2, VHL

Optional MLPA Set
MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, PMS2

Urological Tumors

Prostate Cancer (CAN03, 13 Genes)

ATM, BRCA1, BRCA2, CHEK2, HOXB13, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, NBN, PALB2, PMS2, RAD51D, TP53

Optional MLPA Set
BRCA1, BRCA2, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, PMS2

Renal Cell Cancer (CAN07, 24 Genes)

BAP1, CDC73, CDKN1C, CHEK2, DICER1, FH, FLCN, GPC3, MET, MITF, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, PMS2, PTEN, SDHA, SDHB, SDHC, SDHD, TP53, TSC1, TSC2, VHL, WT1

Optional MLPA Set
MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, PMS2

Urinary Tract Tumors (CAN19, 8 Genes)

ATM, BRCA1, BRCA2, CHEK2, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, MUTYH

Optional MLPA Set
BRCA1, BRCA2, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6

Skin Cancers

Melanoma (CAN09, 14 Genes)

ACD, ATM, BAP1, BRCA2, CDK4, CDKN2A, MBD4, MITF, POT1, PTEN, RB1, TERF2IP, TERT, TP53

Optionale MLPA
BRCA2

Basal Cell Carcinoma (CAN20, 5 Genes)

BAP1, PTCH1, PTCH2, SUFU, TERT

Lung Cancer

Lung Cancer (CAN18, 5 Genes)

BRCA1, BRCA2, CHEK2, EGFR, TP53

Optional MLPA Set
BRCA1, BRCA2

Solid Pediatric Tumors

Solid Pediatric Tumors (CAN22, 36 Genes)

ALK, APC, BLM, BRCA2, CTR9, DICER1, DIS3L2, GPC3, HRAS, MEN1, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, NBN, NF1, NF2, PALB2, PHOX2B, PMS2, PRKAR1A, PTCH1, PTEN, RB1, RECQL4, REST, RET, SMARCA4, SMARCB1, STK11, SUFU, TP53, TRIM28, TSC1, TSC2, VHL, WT1

Optional MLPA Set
BRCA2, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, PMS2

Other Familial Tumor Diseases

Other Familial Tumor Diseases (CAN05, 32 Genes)

AKT1, ATR, BAP1, BLM, BRCA1, BRCA2, CDC73, CHEK2, CYLD, FH, FLCN, LZTR1, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, NF1, NF2, PIK3CA, PMS2, PTEN, SDHB, SDHC, SDHD, SEC23B, SMARCB1, SPRED1, STK11, TP53, TSC1, TSC2, VHL, WRN

Optional MLPA Set
BRCA1, BRCA2, MLH1, MSH2 (incl. epigenetically relevant elements in the 3‘ region of EPCAM), MSH6, PMS2

For Xeroderma Pigmentosum (formerly CAN08) and Fanconi anemia (formerly CAN10) please refer to order forms skin diseases (DRM10) and blood disorders (BLD05).

Gene Directory – Panel for Hereditary Tumor Syndromes

ABRAXAS1, ACD, AIP, AKT1, ALK, APC, ATM, ATR, AXIN2, BAP1, BARD1, BLM, BMPR1A, BRCA1, BRCA2, BRIP1, CDC73, CDH1, CDK4, CDKN1A, CDKN1B, CDKN1C, CDKN2A, CDKN2B, CDKN2C, CHEK2, CTNNA1, CTR9, CYLD, DICER1, DIS3L2, DLST, EGFR, EGLN1, ELP1, EPCAM, FANCA, FANCB, FANCC, FANCD2, FANCE, FANCF, FANCG, FANCI, FANCL, FANCM, FH, FLCN, GPC3, GREM1, HOXB13, HRAS, KIF1B, KIT, LZTR1, MAX, MBD4, MDH2, MEN1, MET, MITF, MLH1, MRE11, MSH2, MSH3, MSH6, MUTYH, NBN, NF1, NF2, NTHL1, PALB2, PDGFRA, PHOX2B, PIK3CA, PMS2, POLD1, POLE, POT1, PRKAR1A, PTCH1, PTCH2, PTEN, RAD50, RAD51C, RAD51D, RB1, RECQL4, REST, RET, RINT1, RNF43, RPS20, SCG5, SDHA, SDHAF2, SDHB, SDHC, SDHD, SEC23B, SLX4, SMAD4, SMARCA4, SMARCB1, SMARCE1, SPRED1, STK11, SUFU, TERF2IP, TERT, TGFBR1, TMEM127, TP53, TRIM28, TSC1, TSC2, VHL, WRN, WT1

Additional Services

HLA-Typing (HLA01)

HLA class I (Gene A, B, C) and HLA class II (Gene DPA1, DPB1, DQA1, DQB1, DRB1, DRB3, DRB4, DRB5)

ACMG Genes

Genetic variation may sometimes be identified, which does not fit within the scope of the requested genetic analysis (so-called secondary findings). The reporting of these variants is limited to pathogenic alterations (ACMG classes 4 and 5) within selected genes, for which a treatment or course of action exists for you or your family (according to the current guidelines of the American College of Medical Genetics and Genomics).

Details on genes and associated diseases can be found here

Pharmacogenetics

Pharmacogenetic analysis detects genetic changes that affect the effectiveness of drugs. Genetic variants that affect proteins responsible for the metabolism of substances can significantly change their tolerance and efficacy. These drugs include, among others, antidepressants, pain relievers, neuroleptics, chemotherapeutics, AIDS drugs, thrombosis drugs, anesthetics, beta-blockers, or statins.

The reduced activity of a specific enzyme can lead to an increased drug level in the standard dosage, which is often associated with undesirable side effects. With drugs that are only activated by metabolism, the therapeutic effect can be completely absent. Likewise, due to the resulting increased rate of degradation of the medicinal substance, an increased enzyme activity leads to inadequate effectiveness of the therapy.

The pharmacogenetics option analyzes known variants in twenty-one genes involved in the metabolism of drugs. If specific gene variants occur, the treating doctor can adapt the therapy individually. The pharmacogenetic analysis can minimize serious side effects and helps to avoid failure of the treatment.

Details on genes and more infomation can be found here

Downloads

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Diagnostic Support

We will assist you in selecting the diagnostic strategy – for each patient.

Tumor team of CeGaT