01 · For Physicians

A trained second pair of eyes before you sign the treatment plan, always by your side.

Tiered, prioritized, resistance-mapped. A 12-section structured advisory with VAF clonality, IO scoring, a 4-step resistance workflow, an NCT trial framework and a VUS registry. Compatible with Tempus xT/xR + RNA-Seq + IHC, FoundationOne, Guardant, Caris and in-house panels. Decision authority stays with the treating physician. We supply the evidence.

Submit a case Talk to Prof. İbrahim Yıldız (15 min) →

133 publications

Prof. Dr. İbrahim Yıldız, medical oncology.

Phase 3 Principal Investigator

Principal Investigator on international clinical trials.

72-hour turnaround

Median turnaround. 48-hour priority, 24-hour STAT.

5 languages

Direct dialogue, signed in your own language.

02 · What you get

Built around your workflow — not the lab's report template.

01

Decision support, not decision replacement

The decision is yours. We organize the evidence: tiered, sourced, traceable all the way to NCCN, ESMO, FDA labels and primary literature. Every recommendation is auditable.

Physician-led, physician-signed

02

Forward-looking, not retrospective

While you prescribe 1L, we map out 2L and 3L. Resistance mutations are flagged ahead of time, together with the exact test to order at progression. No catching up later.

1L → 2L → 3L+ planning

03

A direct line

Every case is open for discussion. Reach Prof. İbrahim Yıldız by phone, email or video call — within 24 hours, in your preferred language. Tumor-board participation available on request.

Colleague to colleague, on request

03 · How a case moves through our process

Five stages. From upload to signed delivery, a 72-hour median.

5 stages · click to review

Stage 01 · Submit

Encrypted intake

Upload Tempus xT/xR + RNA-Seq + IHC, FoundationOne, Guardant, Caris, or any in-house panel. A sample QC dashboard is processed (purity, DNA coverage, RIN, FFPE block age, fixation). Based on stage and prior-treatment completeness, the case is flagged as full MODE-1 or partial MODE-2 advisory. GDPR and KVKK-compliant, encrypted transfer.

Stage 02 · Integration

DNA · RNA · IHC · germline

A single panel rarely sees the whole picture. We cross-check SNVs, indels, fusions, expression and protein data, and flag discordances (e.g. an RNA fusion present with no matching DNA call).

Stage 03 · Tier classification

Tier IA → IV, tumor-specific

AMP/ASCO/CAP tiers are re-assessed against the patient's specific tumor and line of therapy. A finding that is Tier IB in LGSC (KRAS G12D + defactinib/avutometinib) can be Tier III in CRC. We do not simply copy the lab's tier. PARPi non-eligibility, IO contraindication and off-label rationale are all documented with a full evidence chain.

Stage 04 · Sequencing & resistance

Plan the next two lines today

For every driver mutation: the recommended 1L, the most likely resistance mutation on progression, the 2L that targets it, and the exact test to order at progression so you lose no time.

Stage 05 · Sign-off

Personally signed, not auto-generated

A 12-section structured NgsAdvisory report (EN), a physician-to-physician note in your own language (TR/EN/BG/RO/BA), an NCT trial framework with HLA-eligibility screening, an action-priority matrix, and an EHR-ready PDF + JSON export.

Accepted formats

FoundationOne CDx Tempus xT Guardant360 Caris MI Illumina TSO500 In-house panel

+ PDF · JSON · VCF · BAM (optional)

xT · DNAKRAS G12D VAF 51.4% · SPRED1 fs · NF1 nonsense

xR · FusionNo fusion detected · FGFR2/ALK/RET/NTRK negative

RNA-SeqSPRED1 low (10th pct) · NF1 reduced (18th pct)

IHCPD-L1 CPS 2 · ER+ 80% · PR+ 40%

KRAS p.G12D · VAF 51.4%Tier IB

LGSC · Defactinib + Avutometinib (NCCN Consensus)

CCND3 amplificationTier II

3L+ · abemaciclib basket trial NCT03310879

SPRED1 p.S217Vfs*4Tier III

VUS · mechanistic support for MEKi

Defactinib + Avutometinib

+ Letrozole · KRAS G12D

↓ MAP2K1/2

MEKi continuation + Fulvestrant

ctDNA · re-biopsy required

↓ CCND3 / NF1↑

3L+

Abemaciclib · TCR-T

NCT03310879 · NCT06218914 (HLA)

Signed output

NgsAdvisory · IYGAS-2025-LGSC-041

—Structured report (EN): 12 sections

—Physician-to-physician note (TR · EN · BG · RO · BA)

—NCT-linked trial-matching file

—EHR-compatible PDF + JSON export

İ. Yıldız

Prof. Dr. İbrahim Yıldız

04 · 11 · 2026

04 · Tiering in practice

De-identified case · LGSC, female, 31. Three RAS-pathway hits combined into a triply-reinforced MEK target — steering the patient away from 1L chemotherapy.

Report IYGAS-2025-LGSC-041 · de-identified

Tempus xT + xR + RNA-Seq + IHC. KRAS p.G12D is the dominant clonal driver (VAF 51.4%, purity-corrected ~75.6%). SPRED1 LOF + NF1 nonsense jointly amplify RAS-ERK output. TP53 wild-type: histotype-molecular concordance. PARPi not indicated (HRD-GSS 29, all HRR genes WT). IO not recommended (score −1, immune-cold).

Tier IB KRAS G12D HRD-neg MODE-2 partial Age 31 · fertility

Re-analysis · 6 mutations

KRAS p.G12D · VAF 51.4% Tier 1

Defactinib + Avutometinib (VS-6766)

NCCN Consensus · RAMP-201 ORR 27-44%

ESR1/PGR · ER+ 80% PR+ 40% Tier 1

Letrozole: concurrent hormonal backbone

GOG-0239 · CBR ~68%

CCND3 amplification Tier 2

Abemaciclib (3L+): basket trial

NCT03310879

SPRED1 p.S217Vfs*4 · 37.6% Tier 3

VUS · strengthens the MEKi rationale

RNA low (10th pct) · informative

NF1 p.Q1294* · 22.1% Tier 3

VUS · ctDNA follow-up at progression

MEKi resistance precursor

HRD-GSS 29 · BRCA1/2 WT Tier 3

PARPi NOT indicated · HRP tumor

All HRR genes WT

04 · Anatomy of a report

Twelve sections. Four moves that change the treatment plan.

Sections 03 · 04: Genomic profile + VAF clonality

Multi-platform data is reconciled into a single source of truth.

Platforms processed

Tempus xT (DNA panel, 648 genes)
Tempus xR (RNA fusion panel)
RNA-Seq (whole transcriptome)
IHC (PD-L1 22C3, ER, PR)

What we extract

Trunk-level driver: VAF + purity-corrected fraction
Subclonal events: resistance precursors flagged
RNA-expression cross-check: confirms LOF calls
A multi-platform coverage map for every biomarker

Sample QC dashboard

Tumor purity ≥20% · DNA coverage ≥35x · RIN ≥7
FFPE block age + fixation window verified
Full MODE-1 vs. partial MODE-2 advisory is flagged

Section 05: AMP/ASCO/CAP tier matrix

Tier IB → IV, re-graded against the patient's tumor and line of therapy.

Tier basis

Tier IB: FDA-approved + tumor-type-specific guideline
Tier II: strong-evidence basket / off-label
Tier III: VUS, mechanistic monitoring
Tier IV: not indicated, explicit contraindication

Evidence chain

NCCN v2.2025 · ESMO · OncoKB v3.18 verified this session
RAMP-201 · GOG-0239 · primary publications cited
PARPi and IO non-eligibility documented (HRD-negative, immune-cold)
Off-label rationale is kept clearly separate from on-label calls

What lab-issued tiers miss

Tier 1 in NSCLC is not Tier 1 in CRC. We re-grade it.
RNA-only fusions that DNA panels miss
VUS reclassification triggers are re-checked quarterly

Sections 07 · 08: Treatment matrix + 4-step resistance workflow

Plan the next two lines today — not at progression.

Line by line

1L: preferred + alternative + clinical trial
2L: ctDNA + tissue re-biopsy at progression
3L+: re-profiling required, basket re-matching
Hormonal / cytotoxic backbone integration is mapped

4-step resistance workflow

Step 1: ctDNA + re-biopsy within 2 weeks of progression
Step 2: classify the mechanism (categories A/B/C/D)
Step 3: mechanism-driven, not empirical, drug selection
Step 4: trial re-matching against the new molecular landscape

IO scoring

TMB · MSI · PD-L1 · a composite score across drivers
Tumor-type override (e.g. immune-cold LGSC ≠ CPS≥1)
A parameter-level visual indicator with rationale

Sections 09 · 11 · 12: NCT framework + evidence + sign-off

Trial matched, HLA checked, physician-signed.

Trial framework

NCT ids · phase · site (city / country) · molecular match
HLA-eligibility screening for restricted trials (TCR-T)
Local + regional + global trial tiers are ranked
Status is verified against clinicaltrials.gov this session

Evidence library

Trials, guidelines, and preclinical data tagged with evidence strength
ORR · PFS · HR values are traced to primary literature
Every claim is tagged [NGS][LIT][WEB][INF]

Sign-off

Action-priority matrix: impact × urgency
Never auto-generated — personally signed by Prof. Dr. İbrahim Yıldız
EHR-ready PDF + JSON + commentary in 5 languages

05 · What you receive

Two documents. One signature.

Document 01 · Structured report

NgsAdvisory clinical report (EN)

A 14-section structured document: auditable, EHR-compatible and written for oncologists.

01Demographics + sample QC dashboard

02Executive summary + urgent actions

03Genomic profile (DNA · RNA · fusion · IHC)

04VAF banding + clonal architecture chart

05AMP/ASCO/CAP tier matrix

06IO scoring with composite indicator

07Treatment matrix (1L / 2L / 3L+)

08Resistance strategy: 4 steps

09Trial framework + HLA eligibility

10VUS registry + reclassification triggers

11Evidence library + literature

12Action-priority matrix + sign-off

PDF JSON EHR-ready

Document 02 · Physician commentary

A physician-to-physician note

Decision-relevant information delivered in your own language. Not a translation — a colleague's commentary.

—What we would do in 1L, and why

—Where the lab report is wrong or incomplete

—What to watch for at progression

—Any open question to discuss with us before you sign off

TR EN BG RO BA

06 · Pricing

Per case, monthly, or embedded in your tumor board.

Per case · Standard

Median 72-hour delivery · structured report + commentary

Tier classification + ranking

Clinical-trial file

One follow-up call (15 min)