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Solid Tumor Expanded Panel

Test code: 93233

This 523-gene test is used to help oncologists deliver precision medicine by providing personalized genomic analysis of patient’s tumor. The expanded panel offers the opportunity for a broader scope of genomic information. For example, it may be useful for patients with limited or ill-defined treatment options and for those considering clinical trials. The addition of tumor mutation burden (TMB) and microsatellite instability (MSI) also enable simultaneous assessment of eligibility for immune checkpoint inhibitors.1 Next-generation sequencing-based tumor profiling is useful for evaluating many genomic biomarkers simultaneously.

Any significant genomic findings are annotated according to Association for Molecular Pathology (AMP) reporting guidelines. A Quest pathologist will review and validate the results and prepare a report for the treating physician.2

Genomic testing allows for some patients to benefit from treatments that target cancer cells containing specific genetic mutations. Guidelines exist for using results from tumor genetic testing for selection of FDA-approved therapies.

Additionally, the solid tumor expanded panel allows for testing of additional genes that may impact alternative treatments available to the patient. Genomic panel testing allows for diverse data generation and streamlined data analysis, which enables enrollment in specific clinical trials and adaptation of treatment strategies.3,4

Clinical trial information provided in this test is solely for informational purposes for the physician and does not constitute any endorsement or a recommendation for enrollment of patients in any trial by Quest Diagnostics, its affiliates, or its employees.

The Solid Tumor Expanded Panel was developed for assessment of advanced solid tumors when diagnosis, prognosis, or treatment selection could be informed by the presence of genomic variants and MSI/TMB status. Clinical situations where this panel may be helpful include the following:

  • Metastatic or locally advanced disease at presentation
  • Tumors with no actionable mutations found in guideline-recommended testing
  • Recurrent or metastatic disease that has progressed through all standard-of-care options
  • Certain rare tumor types
  • Tumors of unknown primary origin

The Solid Tumor Expanded Panel uses next-generation sequencing to detect mutations present in DNA and RNA extracted from formalin-fixed, paraffin embedded (FFPE) tissue sections of solid tumors. The test is designed to detect single nucleotide variants (SNVs) and small insertions/deletions, as well as whole-gene copy number alterations and translocations in a select group of genes. Microsatellite instability (MSI) and/or tumor mutation burden (TMB) is also evaluated. 

Table showing Gene Content of Solid Tumor Expanded Panel (click to open in new tab).

  • Preferred: Room-temperature, formalin-fixed, paraffin-embedded (FFPE) tissue block containing 200 mm2 of tumor tissue with ≥20% tumor content
  • Minimum: 10 mm2 of tumor tissue with ≥10% tumor content

Yes. The Solid Tumor Core Panel (test code 93234) may be considered. This test provides information on 49 genes from a patient’s tumor specimen that may be helpful in guiding cancer treatment. The genes were selected based on actionability of mutations identified in those genes, using currently available evidence from national and international guidelines and literature. Actionability is defined as information a clinician might find useful to aid in diagnosis, prognosis and/or treatment strategy for a patient.5,6

Please contact our dedicated customer service team at 1.833.773.1441.

To discuss possible germline implications of a test result with a Quest genetic counselor, please call Quest Genomic Client Services at 1.866.GENE.INFO (1.866.436.3463).

On average, results will be completed within 14 days after receipt of the sample in the laboratory. Turnaround time may vary based on delays caused by incomplete orders.


  1.  Li MM, Datto M, Duncavage EJ, et al. Standards and Guidelines for the Interpretation and Reporting of Sequence Variants in Cancer: A Joint Consensus Recommendation of the Association for Molecular Pathology, American Society of Clinical Oncology, and College of American Pathologists. J Mol Diagn. 2017;19(1):4-23. doi:10.1016/j.jmoldx.2016.10.002
  2. Gong J, Pan K, Fakih M, Pal S, Salgia R. Value-based genomics. Oncotarget. 2018;9(21):15792-15815. Published 2018 Jan 30. doi:10.18632/oncotarget.24353
  3. Frampton GM, Fichtenholtz A, Otto GA, et al. Development and validation of a clinical cancer genomic profiling test based on massively parallel DNA sequencing. Nat Biotechnol. 2013;31(11):1023-1031. doi:10.1038/nbt.2696
  4. Zehir A, Benayed R, Shah RH, et al. Mutational landscape of metastatic cancer revealed from prospective clinical sequencing of 10,000 patients [published correction appears in Nat Med. 2017 Aug 4;23 (8):1004]. Nat Med. 2017;23(6):703-713. doi:10.1038/nm.4333
  5. Bieg-Bourne CC, Millis SZ, Piccioni DE, et al. Next-Generation Sequencing in the Clinical Setting Clarifies Patient Characteristics and Potential Actionability. Cancer Res. 2017;77(22):6313-6320. doi:10.1158/0008-5472.CAN-17-1569
  6.  Luchini C, Bibeau F, Ligtenberg MJL, et al. ESMO recommendations on microsatellite instability testing for immunotherapy in cancer, and its relationship with PD-1/PD-L1 expression and tumour mutational burden: a systematic review-based approach. Ann Oncol. 2019;30(8):1232-1243. doi:10.1093/annonc/mdz116


This FAQ is provided for informational purposes only and is not intended as medical advice. Test selection and interpretation, diagnosis, and patient management decisions should be based on the clinician’s education, clinical expertise, and assessment of the patient.


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