{ "metadata": { "name": "MR. ARUN ANAND", "cr_no": "392122", "age_sex": "71 Years/ Male", "referred_doctor": "DR. ULLAS BATRA", "sample_type": "Tumor Tissue (FFPE block) – B/8512/26(1-3)", "diagnosis": "Metastatic non-small cell lung carcinoma (adenocarcinoma)", "tumor_fraction": "80%", "order_no": "", "order_date": "22-07-2026", "receiving_date": "23-07-2026", "reporting_date": "27-08-2026", "lab_id": "2026203-19396" }, "report_information": { "panel_title": "NGS SMART Lung Panel" }, "clinical_content": { "sections": [ { "heading": "Report Highlights", "order": 1, "content": "Alteration detected", "page": 1, "source_lines": [ 52 ], "children": [ { "kind": "list_item", "content": "BRAFp.(Asn581Ser)", "page": 1, "order": 2 }, { "kind": "list_item", "content": "TP53p.(Glu204Ter)", "page": 1, "order": 3 }, { "heading": "DNA Sequence Variants", "order": 4, "page": 1, "source_lines": [ 56 ], "children": [ { "kind": "table", "headers": [ "Gene", "Transcript", "Genomic Locus", "Coding DNA change", "Amino Acid Change", "Variant Allele Frequency", "Variant Type", "Clinical Significance" ], "rows": [ [ "BRAF", "NM_004333.6", "chr7:140453193", "c.1742A>G", "p.(Asn581Ser)", "30.81%", "Missense", "Strong" ], [ "TP53", "NM_000546.6", "chr17:7578239", "c.609_610insT", "p.(Glu204Ter)", "61.62%", "INDEL", "Strong" ] ], "order": 5 }, { "heading": "Genomic Assembly", "order": 6, "content": "GrCH 37(hg19)\nReport Summary:BRAFp.(Asn581Ser) is a likely oncogenic driver, while TP53p.(Glu204Ter) is a oncogenic\ncooperating alteration associated with loss of p53 function and potentially adverse prognosis.", "page": 1, "source_lines": [ 84, 86, 87 ] } ] }, { "heading": "Clinical Significance", "order": 7, "page": 1, "source_lines": [ 105 ], "children": [ { "heading": "Variant: BRAFp.(Asn581Ser)", "order": 8, "page": 1, "source_lines": [ 89 ], "children": [ { "heading": "Pathogenic Contribution", "order": 9, "content": "Likely oncogenic BRAF variant class 3 (non-V600) that can activate MAPK signaling and act as a\ndriver alteration in NSCLC.", "page": 1, "source_lines": [ 90, 91, 92 ] }, { "heading": "Predictive/Therapeutic Significance", "order": 10, "content": "Biologically relevant but not an approved target for BRAF/MEK inhibitors; clinical benefit remains\nuncertain and evidence is limited.", "page": 1, "source_lines": [ 94, 95, 96 ] }, { "heading": "Prognostic Significance", "order": 11, "content": "No consistent evidence that this variant independently affects prognosis.", "page": 1, "source_lines": [ 98, 99 ] }, { "heading": "Diagnostic Significance", "order": 12, "content": "Supports molecular classification as BRAF-mutant NSCLC but is not subtype-specific.", "page": 1, "source_lines": [ 101, 102 ] } ] }, { "heading": "Variant: TP53p.(Glu204Ter)", "order": 13, "page": 2, "source_lines": [ 155 ], "children": [ { "heading": "Pathogenic Contribution", "order": 14, "content": "Pathogenic truncating nonsense variant predicted to cause loss of p53 tumour-suppressor function.", "page": 2, "source_lines": [ 156, 157 ] }, { "heading": "Predictive/Therapeutic Significance", "order": 15, "content": "There are no FDA-approved or NCCN-compendium listed treatments specifically for patients with\nTP53 truncating mutant non-small cell lung cancer.", "page": 2, "source_lines": [ 159, 160, 161 ] }, { "heading": "Prognostic Significance", "order": 16, "content": "Generally associated with more aggressive disease and poorer outcomes in NSCLC.", "page": 2, "source_lines": [ 163, 164 ] }, { "heading": "Diagnostic Significance", "order": 17, "content": "Not diagnostic of a specific NSCLC subtype.", "page": 2, "source_lines": [ 166, 167 ], "children": [ { "heading": "Additional Note", "order": 18, "content": "Report summary was conveyed to Dr. Ullas Batra’s clinical team on 26/8/2026, 12:35 pm.", "page": 2, "source_lines": [ 169 ] } ] } ] } ] }, { "heading": "Assay Information and Methodology", "order": 19, "content": "The assay utilizing a minimum of 10ng of DNA and 10ng of RNA at 500X coverage provides an analytical sensitivity of more than equal to 5\npercent for DNA-based genetic alteration.\nVariants of strong and potential clinical significance are only reported in somatic panels.", "page": 2, "source_lines": [ 171, 198, 199, 202 ], "children": [ { "heading": "Test Description", "order": 20, "content": "– This customized panel is a multi-biomarker next generation sequencing assay that interrogates the under mentioned genes for\nSingle nucleotide Variants (SNVs) and Fusion Rearrangements as mentioned below.", "page": 2, "source_lines": [ 174, 175 ] }, { "heading": "Genes Analyzed for SNVs", "order": 21, "content": "AKT1, ALK, BRAF, EGFR, ERBB2, KRAS, KEAP1, MET, NRAS, NTRK1, PTEN, RB1, ROS1, TP53, STK11,SMARCA4", "page": 2, "source_lines": [ 178 ] }, { "heading": "Genes Analyzed for Rearrangements", "order": 22, "content": "ABL1, AKT3, ALK, AXL, BRAF, EGFR, ERBB2, ERG, ETV1, ETV4, ETV5, FGFR1, FGFR2, FGFR3, MET, NTRK1, NTRK2,\nNTRK3, PDGFRA, PPARG, RAF1, RET, ROS1, SMO.", "page": 2, "source_lines": [ 181, 182 ] }, { "heading": "Quality Metrics", "order": 23, "metrics": { "DNA": { "status": "PASSED", "Mean depth of coverage": "2551", "Uniformity": "93.32%" }, "RNA": { "status": "PASSED", "Total mapped fusion reads": "217211 (Cutoff for QC Pass >20,000)" } }, "page": 2, "source_lines": [ 185, 187, 189, 191, 193, 195 ] }, { "heading": "Disclaimer", "order": 24, "content": "The information in this report does not constitute a treatment recommendation or recommendation to not use any specific therapeutic agent,\nand it should not be interpreted as treatment advice. Decisions concerning patient care and treatment rest solely within the discretion of the patient's\ntreating physician.", "page": 2, "source_lines": [ 205, 206, 207 ] } ] } ] } ] }, "authorization": { "performed_by": "Mamta Arya Scientist C\nAkash Kumar Scientist B\nMolecular Diagnostics", "reviewed_by": "Dr. Sayak Ghatak\nSenior Consultant\nMolecular Diagnostics", "approved_by": "Dr. Anurag Mehta\nPrincipal Director Laboratory Services\nRajiv Gandhi Cancer Institute & Research Centre.\nRohini, New Delhi." }, "processing": { "source_file": "/app/uploads/29388_Lung COE NGS only Panel(Saarthi).pdf", "content_hash": "553cf95ebf6113a5364fe6b7f007a41f2f81826f6873a341d8d1d9338701dbc6", "processed_at": "2026-09-12T12:08:20.150093+00:00", "pipeline_version": "1.0.0", "pipeline_name": "molecular", "pages": 2, "sections_detected": 1, "warnings_count": 0, "skipped_image_blocks": 2, "skipped_figure_lines": 0, "content_coverage": 0.9823, "validation_status": "PASSED", "validation_failures": [], "validation_warnings": [], "header_layout": "B" } }