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TEST:
MSK-IMPACT

Type:
FDA Authorized (EUA/De Novo)
Related tests:
1m
Tumour Mutational Burden and Its Relationship with Clinical Outcomes in Locally Advanced and Recurrent/Metastatic Adenoid Cystic Carcinoma with and Without NOTCH Pathway Activation. (PubMed, Cancers (Basel))
LA-R/M ACC has a low TMB profile overall. Median TMB was higher in NOTCH-activated ACC in both the NHS and MSK groups and TMB may have value in further stratifying patients with LA-R/M ACC.
Clinical data • Journal • Tumor mutational burden
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TMB (Tumor Mutational Burden) • NOTCH1 (Notch 1) • NOTCH2 (Notch 2)
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TMB-L
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FoundationOne® CDx • MSK-IMPACT
2ms
The Genomic Landscape of MYC, MYCL, and MYCN Amplified Solid Tumors. (PubMed, Clin Cancer Res)
Our results suggest that MYC-dependency likely depends on many factors including, but not limited to, total copy number of the detected amplification, lineage specific factors, concomitant presence or absence of additional oncogenic alterations, and in some cases amplification focality.
Journal
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MYC (V-myc avian myelocytomatosis viral oncogene homolog) • MYCN (MYCN Proto-Oncogene BHLH Transcription Factor) • MYCL (MYCL Proto-Oncogene BHLH Transcription Factor)
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MYCN amplification
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MSK-IMPACT
2ms
Clinicopathological analysis of SMARCA4-deficient tumors of digestive system origin (PubMed, Zhonghua Zhong Liu Za Zhi)
These tumors are highly aggressive with poor prognosis. The limited sample size shows a polarized trend in survival data.
Journal • IO biomarker
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SMARCA4 (SWI/SNF related, matrix associated, actin dependent regulator of chromatin, subfamily A, member 4)
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MSK-IMPACT
2ms
TumorOriginPredictor: A Clinically Validated and Cloud-Deployed AI Platform for Tissue-of-Origin Identification in Cancer of Unknown Primary Using Somatic Mutation Profiles. (PubMed, AMIA Jt Summits Transl Sci Proc)
Evaluated as a single platform, TumorOriginPredictor achieved over 72% top-3 accuracy across 12 cancer types and exceeded 80% for prevalent cancers. Clinically validated with 770 real-world profiles and deployed on Azure cloud, it provides real-time predictions, promoting individualized treatment by eliminating empirical therapies, reducing costs and time, and improving survival through a scalable, trustworthy AI platform.
Journal
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MSK-IMPACT
2ms
NF1 mutation may be associated with lung-tropic metastasis in cutaneous melanoma: a genomic analysis of 520 patients. (PubMed, Clin Exp Metastasis)
NF1 mutation is the strongest gene-level correlate of lung-selective metastasis in cutaneous melanoma. The NF1-mutant subtype may represent a dual-biomarker population and could warrant both pulmonary surveillance and prospective evaluation for immunotherapy.
Journal • Tumor mutational burden • PD(L)-1 Biomarker • IO biomarker
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BRAF (B-raf proto-oncogene) • TMB (Tumor Mutational Burden) • NRAS (Neuroblastoma RAS viral oncogene homolog) • NF1 (Neurofibromin 1)
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TMB-H • BRAF mutation • NRAS mutation • BRAF wild-type • RAS wild-type
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MSK-IMPACT
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Keytruda (pembrolizumab)
2ms
Gene-Specific Analysis of Clonal Hematopoiesis Identifies ASXL1 as a Risk Factor for Lung Cancer. (PubMed, bioRxiv)
In addition, rare germline variant association analysis revealed that germline variation in ASXL1 had the strongest association with lung cancer susceptibility among all solid tumors. Collectively, our findings support a model in which smoking-associated expansion of ASXL1-mutant clones contributes to lung cancer development and suggest that gene-specific CHIP metrics may enhance risk stratification and early detection strategies.
Journal
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ASXL1 (ASXL Transcriptional Regulator 1)
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ASXL1 mutation
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MSK-IMPACT
2ms
Beyond Histology: A Dual-Cohort Genomic Analysis of 2901 Endometrial Carcinomas Reveals Class-Level Mismatch Repair Effects and Refines Molecular Classification. (PubMed, Genes (Basel))
We additionally characterize Uterine Clear Cell Carcinoma as a distinct histologic entity (n = 73; 3.0%) and report the POLE + TP53 co-mutant group (n = 90; 3.8%). These findings refine the molecular classification of EC in clinically meaningful ways: they support class-level immunotherapy eligibility based on dMMR status regardless of the specific MMR gene altered, demonstrate that POLE-ultramutated classification requires variant-level pathogenicity assessment, and identify TP53-mutant/CNH patients as the population with the most urgent unmet therapeutic need.
Journal • Mismatch repair • Tumor mutational burden • IO biomarker
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TP53 (Tumor protein P53) • TMB (Tumor Mutational Burden) • MLH1 (MutL homolog 1) • MSH6 (MutS homolog 6) • MSH2 (MutS Homolog 2) • PMS2 (PMS1 protein homolog 2)
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TP53 mutation • MSI-H/dMMR
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MSK-IMPACT
3ms
Prevalence of Germline Pathogenic RET Variants in a Pan-Cancer Patient Population. (PubMed, JCO Precis Oncol)
In this pan-cancer cohort, 71% of RET LP/PV findings were incidental, with no prior personal or family history of MTC. High-risk surveillance and potential thyroidectomy are warranted in patients with an incidental germline RET LP/PV finding due to high rates of precursor lesions and MTC even among these patients.
Journal • Pan tumor
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RET (Ret Proto-Oncogene)
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MSK-IMPACT
3ms
Multimodal Impact of Number of Metastases and Genetic Alterations on Survival in Metastatic Non-Small Cell Lung Cancer. (PubMed, JCO Precis Oncol)
The cutpoint that maximized difference in OS was four metastases, but incorporating genetic alteration information modified this criterion. These findings were proof of principle that integrating multimodal data beyond number of lesions can better identify patients with metastatic NSCLC who may be candidates for MDT.
Journal • Tumor mutational burden
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EGFR (Epidermal growth factor receptor) • ALK (Anaplastic lymphoma kinase) • TMB (Tumor Mutational Burden) • KMT2D (Lysine Methyltransferase 2D)
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MSK-IMPACT
3ms
Driver Mutations Behave Differently Based on Context, Study Finds. (PubMed, Cancer Discov)
A new analysis of tumor data from the MSK-IMPACT dataset revealed that the effects of cancer driver mutations differ based on their context, and that HLA alleles vary considerably by ancestry. Both findings have potential therapeutic implications.
Journal
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MSK-IMPACT
3ms
Novel genomic risk stratification model for primary high-grade malignant peripheral nerve sheath tumor (MPNST). (PubMed, J Pathol)
Collectively, genomic alterations detected by clinical NGS panels provide potential new biomarkers for risk stratification that can be integrated with conventional parameters to provide improved prognostication and guide therapeutic strategies.
Journal
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TP53 (Tumor protein P53) • CDKN2A (Cyclin Dependent Kinase Inhibitor 2A) • NF1 (Neurofibromin 1) • TERT (Telomerase Reverse Transcriptase) • CDKN2B (Cyclin Dependent Kinase Inhibitor 2B) • SUZ12 (SUZ12 Polycomb Repressive Complex 2 Subunit)
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TP53 mutation • TP53 wild-type • CDKN2A deletion
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MSK-IMPACT
3ms
NIMBUS: Nivolumab Plus Ipilimumab in Metastatic Hypermutated HER2-negative Breast Cancer (clinicaltrials.gov)
P2, N=30, Active, not recruiting, Dana-Farber Cancer Institute | Trial completion date: Feb 2026 --> Feb 2027
Trial completion date • IO biomarker
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HER-2 (Human epidermal growth factor receptor 2) • PGR (Progesterone receptor) • TMB (Tumor Mutational Burden)
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HR positive • HER-2 amplification • HER-2 negative • PGR positive • HER-2 negative + AR positive + ER positive
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MSK-IMPACT • OncoPanel™ Assay
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Opdivo (nivolumab) • Yervoy (ipilimumab)