Closing Cancer Cases Not Under Active Care Angela Douglas MBE Clinical Programme Director NW Coast Genomic Medicine Centre

Return of Results in Portal / Close Cases in Portal Not Validated Scientist/Clinician Identification of relevant genes/variants clinical trials Genomic MDT Group Validation Integrated report Tumour specific MDT Other diagnostic tests Clinical Discussion with patient about further treatment Relevant Results to patient Through follow up /when relapsed Results to clinician for review Decision about treatment Patient treatment

Presentation at MDT

Information for MDT Prepared by Scientist in collaboration with Clinician or Recruitment Nurse Patient: DOB: NHS No: Hospital No: Hospital Name: Consultant: Cancer Type: Subtype: Participant ID: Deceased: Patient is/ is not currently on an active pathway FF Not FFPE

List domain 1 somatic variants identified in report and highlight any relevant to patient List domain 2 somatic variants highlight any relevant to patient Highlight any pertinent structural variants of cancer genes Highlight any pertinent germline cancer susceptibility variants that were identified Number of somatic non-synonymous SNVs per megabase (coding region): x = ? =/ Not HIGH TMB

Mutation signature FF Not FFPE aetiology remains unknown likely due to tobacco mutagens ? deficient relevant signature

GTAB Decision outcome Following Discussion Outcomes from MDT: NO validation required at present patient has not reoccurred

Return of Results in Portal / Close Cases in Portal Not Validated Scientist/Clinician Identification of relevant genes/variants clinical trials Genomic MDT Group Validation Integrated report Tumour specific MDT Other diagnostic tests Clinical Discussion with patient about further treatment Relevant Results to patient Through follow up /when relapsed Results to clinician for review Decision about treatment Patient treatment