Understanding the IYGAS Structured Report
How the report is organized and why it is built this way, so you know what will land in your hands before you submit a case.
A genomic laboratory gives you a profile. A free-text second opinion gives you an answer. Neither one, on its own, is built to be used.
Neither is designed to be carried into a tumor board, shared with the 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 concluded, but the reasoning behind every finding, the level of evidence, and the limitations. This page explains how the report is organized and why it is built this way, so you know what will land in your hands before you submit a case.
A genomic profile is not an interpretation. A free-text note cannot be audited. The IYGAS report is designed to be used in a tumor board, with the treating physician, and again six months later.
Why structure matters
Most second opinions are defined by two failures. 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 that carries no visible trail from finding to recommendation.
A structured report solves both. Every case moves through the same sections in the same order, so nothing is skipped and any reader can find exactly the part they need. Consistency here is not bureaucracy; it is what makes the document trustworthy and reusable.
How the report is read
The report is organized so that a busy oncologist can either read it from start to finish and follow the logic, or jump directly to the section they need. The sections are grouped into four parts.
1Orientation: what are we looking at?
Clinical context and 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, this is stated, not assumed.
Executive summary
The bottom line up front, in a few lines, for the reader who needs to see the essence before the detail.
2Evidence: what did we find, and do we believe it?
Genomic and biomarker profile
All reported alterations and biomarkers, organized rather than simply listed.
VAF and clonality interpretation
Whether each alteration is clonal or subclonal, and what that implies for whether it should be acted on.
Tier classification AMP · ASCO · CAP
Every alteration is graded against an established framework, so “actionable” carries a defined meaning rather than a label.
VUS registry
Variants of uncertain significance are documented transparently rather than discarded, so nothing is silently dropped and future reclassification remains possible.
Evidence library
The support underlying the core conclusions is kept with the report, so the rationale travels with the document.
3Decision: what should happen, and when?
Treatment decision matrix 1L · 2L · 3L+
Options are mapped to the patient's actual position: what is appropriate now, what is held in reserve, and the intended sequence. A biomarker with no matched treatment is documented honestly, exactly as it is.
Immunotherapy eligibility
Signals relevant to immunotherapy are assessed together, not in isolation.
Resistance management strategy
The likely resistance mechanism and monitoring plan are considered in advance, so the recommendation is a strategy rather than a single move.
Clinical trial matching
Relevant trials are identified; off-label rationale is presented strictly at its stated level of evidence, never as an established standard.
4Outcome: the consulting opinion
Physician consulting outcome
The integrated recommendation is written so that another oncologist or a tumor board can understand not only what we recommend but why.
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 shows this explicitly rather than burying it in prose.
- Evidence badges (full / partial / single point, shown as ●●● / ●●○ / ●○○) mark the strength behind every core statement at a glance.
- Access labels mark where an option's real-world availability may vary by setting, so a recommendation that is elegant on paper but impractical in practice is honestly flagged.
- Conditional footnotes are attached to findings tied to a caveat — a borderline VAF, a purity limit — so a conditional conclusion never reads as an unconditional one.
This layer is what separates a confident-sounding opinion from a calibrated one. You can see where the ground is solid and where it is not.
How the report is used
The document is built to keep working after it is delivered.
1In a tumor board
The structured sections and evidence tiers let a group reason from the same page rather than from a verbal summary.
2With the treating physician
The consulting outcome and decision matrix are written to be handed directly to the clinician managing the patient.
3Over time
The VUS registry and evidence library turn the report into a living reference; when the patient progresses or the guidelines change, the earlier reasoning is still legible.
The point
The IYGAS report exists so that a complex molecular case produces something more durable than an answer: a structured, calibrated, auditable document a physician can act on, defend, and return to.
Structure is the product, at least as much as the conclusion is.
This content is for educational purposes only. It does not constitute individual medical advice and does not replace the judgment of the treating physician.
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