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NGS Academy · C3 · Methodology Intermediate

Understanding the IYGAS Structured Report

How the report is organized and why it's built the way it is, so you know what arrives before you submit a case.

Why this page exists

A genomic profile is uninterpreted. A free-text note is unauditable. The IYGAS report is designed to be used, in a tumor board, with a treating physician, six months later.

Methodology · The IYGAS structured report Physicians & tumor boards

A genomic laboratory hands you a profile. A free-text second opinion hands you an answer. Neither, on its own, is built to be used.

Neither is meant to be taken into a tumor board, shared with a treating physician, or revisited six months later when the patient progresses. The IYGAS report is designed for exactly that: a structured document that shows not only what we conclude, but the reasoning, the evidence level, and the limits behind every conclusion. This page explains how the report is organized and why it's built the way it is, so you know what arrives before you submit a case.

C3.1 · Part one

Why structure matters

Two failures define most second opinions. The first is the raw genomic PDF, accurate but uninterpreted, leaving the clinical decision entirely to the reader. The second is the unstructured expert note, interpreted but unauditable, an answer with no visible trail from finding to recommendation.

A structured report solves both. Every case runs through the same sections in the same order, so nothing is skipped and any reader can locate exactly the part they need. Consistency is not bureaucracy here, it's what makes the document trustworthy and reusable.

C3.2 · Part two

How the report reads

The report is organized so that a busy oncologist can read it top to bottom and follow the logic, or jump straight to the section they need. The sections group into four movements.

1

Orientation, what are we looking at?

Clinical context & demographics

The reconstructed clinical picture: tumor type, histology, stage, prior lines and response, current status, and the specific question the case is asking. Where data is missing, it's stated, not assumed.

Executive summary

The conclusion up front, in a few lines, for the reader who needs the bottom line before the detail.

2

The evidence, what did we find, and do we believe it?

Genomic & biomarker profile

The full set of reported alterations and biomarkers, organized rather than listed.

VAF & clonality interpretation

Whether each alteration is clonal or subclonal, and what that implies for whether it should be acted on at all.

Tier classification AMP · ASCO · CAP

Every alteration graded against an established framework, so "actionable" carries a defined meaning rather than a label.

VUS registry

Variants of uncertain significance documented transparently rather than dropped, so nothing is silently discarded and re-classification later is possible.

Evidence library

The supporting basis for the key conclusions, kept with the report so the reasoning travels with the document.

3

The decision, what should happen, and when?

Treatment decision matrix 1L · 2L · 3L+

Options mapped onto the patient's actual position: what's appropriate now, what's held in reserve, and the intended sequence. A biomarker with no matched therapy is documented honestly as exactly that.

Immunotherapy suitability

The immunotherapy-relevant signals weighed together rather than in isolation.

Resistance management strategy

The likely resistance mechanism and monitoring plan thought through in advance, so the recommendation is a strategy and not a single move.

Clinical trial matching

Relevant trials identified, with off-label rationales presented at their stated evidence level, never as an established standard.

4

The conclusion, the advisory

Physician advisory conclusion

The integrated recommendation, written so another oncologist or a tumor board can understand not just what we advise, but why.

C3.3 · Part three

The calibration layer: how confidence is shown

A recommendation is only as useful as the reader's ability to judge how solid it is. The report makes that explicit rather than burying it in prose.

  • Evidence badges (full / partial / single dot, shown as ●●● / ●●○ / ●○○) mark the strength behind each key statement at a glance.
  • Access tags flag where an option's real-world availability may differ by setting, so a recommendation that's elegant on paper but inaccessible in practice is identified honestly.
  • Conditional footnotes attach to interpretations that depend on a caveat, a borderline VAF, a purity limit, so a qualified conclusion is never read as an unqualified one.

This layer is what separates a confident-sounding opinion from a calibrated one. You can see where the ground is firm and where it isn't.

C3.4 · Part four

How to use the report

The document is built to do work after it's delivered.

1

In a tumor board

The structured sections and evidence tiers let a group reason from the same page rather than from a verbal summary.

2

With the treating physician

The advisory conclusion and decision matrix are written to hand directly to the clinician managing the patient.

3

Over time

The VUS registry and evidence library make the report a living reference; when the patient progresses or guidelines shift, the earlier reasoning is still legible.

C3.5 · In closing

The point

The IYGAS report exists so that a complex molecular case produces something more durable than an answer: a structured, calibrated, auditable document that a physician can act on, defend, and return to.

The structure is the product as much as the conclusion is.

Disclaimer

This content is intended for educational purposes only. It does not constitute individual medical advice and should not replace evaluation by the treating physician.

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