All Major Solid Tumors

Cancer Type

Blood

Specimen Requirements

12 Working Days

Turnaround Time ¹

ACTRisk™ hereditary gene testing decodes 67 cancer genes associated with 9 common hereditary cancers and 11 cancer syndromes, which provides additional information to a health management strategy.

Genetic Testing For Hereditary Cancers

67

Specially Curated Genes

9

Common Hereditary Cancers

11

Cancer Syndromes

Hallmarks

Provides Information on 67  Hereditary Cancer Genes

The test can be done with just one blood draw, and a comprehensive evaluation of 9 major hereditary cancers and 11 cancer syndrome genes can be obtained by using whole exome sequencing.

Bioinformatics Analysis Based on International Databases

Extracts up-to-date information from international databases, namely GnomAD, 1000 Genome, ClinVar, COSMIC and ACT Genomics' in-house ethnographic database.

Genetic Testing with High Accuracy

Uses next-generation sequencing (NGS) technology to detect various types of mutations such as SNV, Small InDel, Splicing Site and LGR.

Detailed Cancer Risk & Clinical Management Reporting

Provides the relevant risk information based on the latest international clinical research literature, provides comprehensive risk factors, and is clear and easy to understand.

Short Turnaround Time

Provides professional solutions within 12 working days (starting from the date of receipt of approved samples at our CAP-accredited laboratory).

Summary

Identifies Hereditary Cancer-Related Genes and Cancer Risk

When multiple cases of cancer occur in a family, it is necessary to consider whether the family members are exposed to a shared intrinsic risk factor arising from the inheritance of cancer-related gene mutations.

What Are Hereditary Cancers?

Approximately 5–10% of cancers are caused by inherited genetic mutations.1 In addition to BRCA1/2 mutations, which are widely known to increase the risk of breast, ovarian, pancreatic and prostate cancers, mutations in many other hereditary cancer-related genes also increase the lifetime risk of cancer by up to 90 times compared with that of the general population (Figure 1).2-5

Although hereditary cancers constitute a small proportion of all cancer cases, they should not be overlooked. Many of the cancer-stricken families carry susceptibility or predisposing genes which are passed down the family across multiple generations. Based on the penetrance rate, these genes can be classified as either high penetrance, moderate penetrance or low penetrance.6 people with moderate-to-high penetrance genes are at significantly higher risk of developing cancer. Therefore, in accordance with the recommendations of the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) guidelines, cancer screening, monitoring and intervention need to be performed early. Indeed, a study in 2017 found that the incidence of colorectal cancer could be reduced if patients with susceptibility gene (e.g., MLH1, MSH2, MSH6, PMS2) mutations underwent regular colonoscopy and polyps removal, which were found to decrease the mortality rate by a staggering 65%.7

How Are Cancer Susceptibility Genes Inherited?

Patients with a hereditary cancer usually have a family history of cancer. Therefore, it is important to consider both the paternal and maternal lines of inheritance. Using hereditary breast and ovarian cancer syndrome (HBOCS) as an example, BRCA1 mutations are inherited in an autosomal dominant fashion (Figure 2). As such, each of the siblings or children would have a 50% chance of carrying the mutant BRCA1 gene from the parent, which predisposes them to the development of hereditary cancers. Therefore, the occurrence rate of these cancers in the affected family would be comparatively higher than others. The onset of these cancers may also be earlier compared with the average age of onset of the respective cancers. Because each hereditary cancer has different characteristics, it is highly recommended that genetic counselling is conducted by a trained professional before and after the tests.

Who Should Be Tested?

  1. Multiple family members who have cancer
  2. Any individual who is concerned about the inherent risk of hereditary cancers and cancer syndromes
  3. A family member who has multiple cancers, an early-onset cancer or a rare cancer

Technical Specifications

Number of Genes Tested

67 hereditary cancer-related genes

Specimen Requirements9

4-8 mL whole blood x 2 tubes

Turnaround Time

12 working days1

Databases Used

  • International databases such as GnomAD, 1000 Genome, ClinVar and COSMIC
  • ACT Genomics' in-house ethnographic database built from published evidence
Genetic Variation

  • Single nucleotide variants (SNVs)
  • Small insertions and deletions (small InDels)
  • Specific exon-intron splicing site mutation of selected genes
  • Large genomic rearrangement (LGR) of 18 genes, including BRCA1/2 and MMR genes

Documentation

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Gene List Filter

Search
Cancer Type
Tier 1 Actionable Genes:

SNV / Indel

CNA

Fusion

*Genes also provide exon-skipping alteration information.

NTRK1/2/3

Breast

Colorectal

Gastric / GEJ

Biliary Tract

Brain (CNS)

SNV / Indel

ERBB2 (HER2)

Lung (NSCLC)

Breast

Colorectal

Gastric / GEJ

Biliary Tract

CNA

Fusion

RET

Lung (NSCLC)

Colorectal

Gastric / GEJ

Brain (CNS)

Breast

SNV / Indel

MET

Brain (CNS)

Colorectal

GIST

Breast

Lung (NSCLC)

CNA

KRAS

Thyroid

Brain (CNS)

Breast

Colorectal

Biliary Tract

Fusion

BRAF

GIST

Colorectal

Gastric / GEJ

Brain (CNS)

Biliary Tract

SNV / Indel

CNA

ROS1

Colorectal

Brain (CNS)

GIST

Lung (NSCLC)

Breast

SNV / Indel

Fusion

ALK

Breast

Colorectal

GIST

Brain (CNS)

Biliary Tract

CNA

Fusion

EGFR

Lung (NSCLC)

Brain (CNS)

Breast

Gastric / GEJ

SNV / Indel

CNA

Fusion

Other Relevant Genes:

MSH6

Lung (NSCLC)

Brain (CNS)

GIST

Colorectal

Breast

CNA

MSH2

Thyroid

Biliary Tract

Lung (NSCLC)

Brain (CNS)

GIST

SNV / Indel

CNA

Fusion

MLH1

Gastric / GEJ

Thyroid

Breast

Biliary Tract

Colorectal

SNV / Indel

Fusion

VHL

Brain (CNS)

GIST

Gastric / GEJ

Thyroid

Breast

Fusion

NF2

Lung (NSCLC)

Brain (CNS)

GIST

Gastric / GEJ

Thyroid

SNV / Indel

CNA

NF1

Biliary Tract

Colorectal

Lung (NSCLC)

Brain (CNS)

GIST

SNV / Indel

TSC2

Breast

Thyroid

Biliary Tract

Colorectal

Lung (NSCLC)

SNV / Indel

Fusion

TSC1

Breast

Gastric / GEJ

Thyroid

Biliary Tract

Colorectal

CNA

IDH2

Breast

Gastric / GEJ

Thyroid

Biliary Tract

Colorectal

SNV / Indel

IDH1

Lung (NSCLC)

Breast

Gastric / GEJ

Thyroid

Biliary Tract

SNV / Indel

CNA

ARID1A

Lung (NSCLC)

Colorectal

Breast

GIST

Gastric / GEJ

SNV / Indel

CTNNB1

Lung (NSCLC)

Colorectal

Breast

GIST

Gastric / GEJ

CNA

APC

Lung (NSCLC)

Colorectal

Breast

GIST

Gastric / GEJ

SNV / Indel

CNA

SMAD4

Lung (NSCLC)

Colorectal

Breast

GIST

Gastric / GEJ

SNV / Indel

Fusion

RB1

Lung (NSCLC)

Colorectal

Breast

GIST

Gastric / GEJ

CNA

Fusion

CDK6

Lung (NSCLC)

Colorectal

Breast

GIST

Gastric / GEJ

CNA

CDK4

Lung (NSCLC)

Colorectal

Breast

GIST

Gastric / GEJ

SNV / Indel

Fusion

CDKN2A

Brain (CNS)

Biliary Tract

Lung (NSCLC)

Colorectal

Breast

CNA

Fusion

STK11

Brain (CNS)

Biliary Tract

Lung (NSCLC)

Colorectal

Breast

SNV / Indel

PTEN

Brain (CNS)

Thyroid

Biliary Tract

Lung (NSCLC)

Colorectal

SNV / Indel

Fusion

RAD51C

Brain (CNS)

Thyroid

Biliary Tract

Lung (NSCLC)

Colorectal

SNV / Indel

CNA

Fusion

RAD51

Breast

Brain (CNS)

Thyroid

Gastric / GEJ

Biliary Tract

SNV / Indel

PALB2

Breast

Brain (CNS)

Thyroid

Gastric / GEJ

Biliary Tract

SNV / Indel

CNA

CHEK2

Breast

Brain (CNS)

Thyroid

GIST

Colorectal

Fusion

CHEK1

Breast

Gastric / GEJ

Brain (CNS)

Biliary Tract

Thyroid

SNV / Indel

ATR

Breast

Gastric / GEJ

Brain (CNS)

Biliary Tract

Thyroid

CNA

ATM

Colorectal

Breast

Gastric / GEJ

Brain (CNS)

Biliary Tract

SNV / Indel

NTRK1

Lung (NSCLC)

Colorectal

Breast

Gastric / GEJ

Brain (CNS)

SNV / Indel

CNA

PDGFRA

Lung (NSCLC)

Colorectal

Breast

Fusion

KIT

Lung (NSCLC)

Breast

Gastric / GEJ

Colorectal

Thyroid

CNA

FGFR3

Brain (CNS)

Biliary Tract

Lung (NSCLC)

Breast

CNA

FGFR2

Colorectal

GIST

Gastric / GEJ

Brain (CNS)

Biliary Tract

SNV / Indel

CNA

FGFR1

Colorectal

GIST

Gastric / GEJ

Brain (CNS)

Biliary Tract

Fusion

ERBB4

Colorectal

GIST

Lung (NSCLC)

Biliary Tract

Gastric / GEJ

SNV / Indel

CNA

Fusion

ERBB3

Breast

Colorectal

GIST

Lung (NSCLC)

Biliary Tract

Fusion

PIK3CA

Breast

Colorectal

GIST

Lung (NSCLC)

Biliary Tract

SNV / Indel

Fusion

NRAS

Breast

Colorectal

GIST

Brain (CNS)

Thyroid

CNA

EGFR

Breast

Colorectal

GIST

Lung (NSCLC)

Biliary Tract

Fusion

TP53

Breast

Colorectal

GIST

Brain (CNS)

Thyroid

SNV / Indel

Fusion

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Disclaimers / Footnotes

  1. Turnaround time starts from the date of receipt of approved samples at our CAP-accredited laboratory.
  2. NIH, Genetic Testing for Inherited Cancer Susceptibility Syndromes.
  3. Kuchenbaecker KB, et al. (2017) JAMA. 317(23):2402–2416.
  4. NCCN Guidelines: Genetic/Familial High-Risk Assessment: Colorectal.
  5. NCCN Guidelines: Genetic/Familial High-Risk Assessment: Breast and Ovarian.
  6. NCCN Guidelines: Gastric Cancer.
  7. Erin F Cobain, et al. (2016) Semin Oncol. 43(5):528–535.
  8. Steel E, et al. (2017) Hered Cancer Clin Pract. 15:1.
  9. Please refer to our specimen instructions.

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