Your second pair of trained eyes,
before you sign the treatment plan.
Tier classified, sequenced, resistance mapped. 12-section structured advisory with VAF clonality, IO scoring, 4-step resistance workflow, NCT trial framework + VUS registry. Compatible with Tempus xT/xR + RNA-Seq + IHC, FoundationOne, Guardant, Caris & in-house panels. The treating physician retains decision authority. We hand you the evidence.
Built around your workflow, not around the laboratory's report template.
You own the call. We arrange the evidence, tiered, sourced, traceable to NCCN, ESMO, FDA labels and primary literature. Every recommendation is auditable.
While you write 1L, we map 2L and 3L. Resistance mutations are preflagged with the assays you'll need to order at progression. No catching up.
Every case is open for discussion. Phone, email, or video with Prof. Yıldız (within 24 h, in your preferred language). Tumor board attendance on request.
Five stages.
Median
72 hours
from upload to signed delivery.
Drop Tempus xT/xR + RNA-Seq + IHC, FoundationOne, Guardant, Caris, or any in-house panel. Specimen QC dashboard ingested (purity, DNA coverage, RIN, FFPE age, fixation). MODE-1 full vs MODE-2 partial advisory flagged based on stage + prior therapy completeness. GDPR & KVKK-aligned, encrypted transport.
A single panel rarely sees the whole picture. We cross reference SNVs, indels, fusions, expression and protein readouts, and flag discordance (e.g. RNA fusion present, DNA call missed).
AMP/ASCO/CAP tiers reevaluated against the patient's tumor and line. A Tier IB in LGSC (KRAS G12D + Defactinib/Avutometinib) sits at Tier III in CRC. We don't read tiers off the lab printout. PARPi non-indication, IO contraindication, and off-label rationale all documented with evidence chain.
For each driver: the recommended 1L, the most probable resistance mutation at progression, the 2L that addresses it, and the assay to order so you don't lose 4 weeks at progression.
NgsAdvisory 12-section structured report (EN), physician to physician commentary in your language (TR/EN/BG/RO/BA), NCT trial framework with HLA eligibility check, action priority matrix, EHR-ready PDF + JSON.
Anonymized case · LGSC, female 31.
Three RAS pathway hits compounded into a
triply reinforced MEK target.
1L pivoted away from chemo.
female, 31, treatment naive
Tempus xT + xR + RNA-Seq + IHC. KRAS p.G12D dominant clonal driver (VAF 51.4%, corrected ~75.6% post-purity). SPRED1 LOF + NF1 nonsense compound RAS-ERK output. TP53 wild-type: histotype-molecular concordance. PARPi not indicated (HRD-GSS 29, all HRR WT). IO not recommended (score −1, immune-cold).
Twelve sections.
Four moves
that change the treatment plan.
- Tempus xT (DNA panel, 648 genes)
- Tempus xR (RNA fusion panel)
- RNA-Seq (full transcriptome)
- IHC (PD-L1 22C3, ER, PR)
- Trunk level driver: VAF + purity corrected fraction
- Subclonal events: resistance precursors flagged
- RNA expression cross check: corroborates LOF calls
- Multi-platform coverage map per biomarker
- Tumor purity ≥20% · DNA coverage ≥35× · RIN ≥7
- FFPE block age + fixation window verified
- MODE-1 full vs MODE-2 partial advisory flagged
- Tier IB: FDA-approved + tumor type specific guideline
- Tier II: basket / off-label with strong evidence
- Tier III: VUS, mechanistic monitor
- Tier IV: non-indicated, explicit contraindication
- NCCN v2.2025 · ESMO · OncoKB v3.18 verified this session
- RAMP-201 · GOG-0239 · primary publications cited
- PARPi & IO non-indication documented (HRD-neg, immune-cold)
- Off-label rationale separated from on-label calls
- A Tier 1 in NSCLC ≠ Tier 1 in CRC. We regrade.
- RNA only fusions DNA panels miss
- VUS reclassification triggers tracked quarterly
- 1L: preferred + alternative + clinical trial
- 2L: ctDNA + tissue re-biopsy at progression
- 3L+: reprofiling mandatory, basket rematch
- Hormonal / cytotoxic backbone integration mapped
- Step 1: ctDNA + re-biopsy within 2 weeks of progression
- Step 2: classify mechanism (A/B/C/D categories)
- Step 3: drug selection by mechanism, not empirics
- Step 4: trial rematch with new molecular landscape
- Composite score across TMB · MSI · PD-L1 · driver
- Tumor type override (e.g. LGSC immune-cold ≠ CPS≥1)
- Visual gauge with parameter level rationale
- NCT IDs · phase · site (city / country) · molecular match
- HLA eligibility check for restricted trials (TCR-T)
- Local + regional + global trial tiers ranked
- Status verified at clinicaltrials.gov this session
- Trials, guidelines, preclinical data with strength labels
- ORR · PFS · HR figures sourced to primary literature
- [NGS][LIT][WEB][INF] tags on every claim
- Action priority matrix: impact × urgency
- Personally signed by Prof. Yıldız, not autogenerated
- EHR-friendly PDF + JSON + 5-language commentary
Two documents.
One signature.
14-section structured document, auditable, EHR-friendly, written for oncologists.
- 01 Demographics + specimen QC dashboard
- 02 Executive summary + immediate actions
- 03 Genomic profile (DNA · RNA · fusion · IHC)
- 04 VAF banding + clonal architecture plot
- 05 AMP/ASCO/CAP tier matrix
- 06 IO scoring with composite gauge
- 07 Treatment matrix (1L / 2L / 3L+)
- 08 Resistance strategy: 4 steps
- 09 Trial framework + HLA eligibility
- 10 VUS registry + reclassification triggers
- 11 Evidence library + literature
- 12 Action priority matrix + signature
The decision relevant story, in your language. Not a translation, a co-clinician's read.
- What we'd do at 1L, and why
- Where the lab report is wrong or incomplete
- What to watch for at progression
- Open question to discuss with us before sign-off
Per case, per month, or embedded in your tumor board.
- · Tier classification + sequencing
- · Trial dossier
- · One follow up call (15 min)
- · Negotiated per case rate
- · Priority 48 h SLA
- · Quarterly literature briefing for the team
- · Dedicated contact line
- · Standard deliverable, plus
- · Live MDT video presence
- · Real time Q&A with Prof. Yıldız
- · Post-MDT amended note
Per-case, institutional and tumor-board engagements are quoted individually. STAT 24-hour delivery is available on all tiers.
Request an institutional quote