What a molecular NGS second opinion includes.
A molecular second opinion re-reads your existing NGS report and turns it into a prioritized treatment roadmap for your specific tumor, reviewed and signed by a medical oncologist. It tells you not only what the report found, but what to do, in what order, and what to avoid.
Medically reviewed by Prof. Dr. İbrahim Yıldız, MD · Professor of Medical Oncology, Acıbadem · Reviewed June 2026
What is a molecular second opinion?
A molecular second opinion is an independent, physician-led re-interpretation of a tumor's NGS data. Rather than repeating the test, it reads the existing report against current guidelines and the literature, then produces a prioritized, sequenced treatment plan, tailored to the patient, that the treating oncologist can act on.
The bottleneck in precision oncology is no longer running the test, it is reading it correctly. A modern panel can return dozens of variants of unknown significance and a short, automated summary that has never met the patient. The second opinion closes the gap between raw genomic data and an actionable, reasoned decision.
What is included in the advisory.
Variant tier classification
Every variant graded Tier I to IV (AMP / ASCO / CAP) and re-graded for your tumor type and treatment line.
Immunotherapy suitability
A transparent score from TMB, MSI, PD-L1 and driver context, with explicit "IO is / is not appropriate" reasoning.
Treatment sequencing
Preferred 1L with alternatives, 2L matched to expected resistance, and 3L+ options, each with evidence level.
Anticipatory resistance plan
What to test at progression, which resistance mechanisms to expect, and which next-generation agents or trials address each.
Multi-platform integration
DNA, RNA and IHC read together, with any discordance (for example RNA-positive but DNA-negative) resolved or flagged for the right confirmatory test.
Clinical trial matching
Molecular and HLA eligibility checked against current trial databases, with NCT, phase and geography.
Physician commentary
A personal letter, physician to physician, from Prof. Dr. İbrahim Yıldız, in the report language you choose.
What it does, and what it does not do.
- Re-reads your existing NGS report against current NCCN, ESMO and OncoKB evidence
- Classifies each variant by actionability (Tier I to IV) for your tumor type
- Sequences options across lines (1L, 2L, 3L+) with anticipated resistance
- Integrates DNA, RNA and IHC where available, and resolves discordance
- Matches molecular and HLA eligibility to active clinical trials
- Delivers a signed advisory plus a physician to physician commentary
- Does not make a diagnosis or replace your treating oncologist
- Is not a medical device and not a substitute for in-person assessment
- Does not order tests, prescribe, or administer any treatment
- Does not require new sequencing; it works with your existing report
- Does not guarantee an outcome; every decision stays with your physician
- Is not an emergency service
NGS Advisory provides decision support for the treating physician. It is not a diagnosis, not a medical device, and does not replace clinical judgment.
Tier I to IV, re-graded for your tumor.
Each variant is graded for clinical actionability using the AMP / ASCO / CAP framework, then re-graded for the specific tumor type and treatment line. A biomarker that is Tier I in one cancer can be Tier II, or irrelevant, in another, so the grade is always read in context.
| Tier | Meaning | What it implies |
|---|---|---|
| Tier I | Strong clinical significance | FDA-approved therapy or guideline consensus for this biomarker in this tumor type. |
| Tier II | Potential clinical significance | Off-label, basket-trial or emerging evidence; reasonable in the right context. |
| Tier III | Unknown significance (VUS) | Biologically interesting but not yet actionable; monitored, not treated on. |
| Tier IV | Benign / likely benign | Not clinically relevant for treatment selection. |
Before you ask.
I already have an NGS report. Why a second opinion on it?
An NGS report lists what was found; it does not build a treatment strategy. A molecular second opinion takes that same data and turns it into a prioritized, sequenced plan, including what not to do, for your tumor type and treatment line.
Do I need new testing?
No. The advisory works with your existing report (Tempus, FoundationOne, Guardant, Caris, or any panel). If multiple platforms are available (DNA, RNA, IHC), they are integrated; new testing is only suggested when a specific result needs confirmation.
Will it replace my oncologist?
No. It is decision support, not a diagnosis. Every recommendation is written for your treating oncologist, who retains full authority over the treatment decision.
How long does it take, and in what language?
The structured advisory is delivered in English (the international standard for molecular genomics), typically within 72 hours, with priority and STAT options. The physician commentary can be delivered in your preferred language.
A second pair of trained eyes, before the plan is signed.
Send your existing NGS report securely. Most advisories are delivered within 72 hours.