PLATFORM MOLECULAR DIAGNOSTICS UZ GHENT (MDG)

For the analysis of specific somatic defects in the DNA, cell free DNA (cfDNA) and RNA of malignant tissue, blood or bone marrow of cancer patients, a collaboration is set up between three laboratories of Ghent University Hospital (Department of Pathological anatomy UZ Gent, Laboratory of clinical biology UZ Gent and the Center for medical genetics UZ Gent) under the platform Molecular Diagnostics UZ Ghent (MDG). The platform MDG combines the expertise of the three laboratories: the tests are requested by the Department of Pathological anatomy or by the Laboratory of clinical biology, subsequently the laboratory tests are performed at the Center for medical genetics.

The core activity of MDG is the detection of acquired defects in DNA, cfDNA and RNA from the malignant tissues, blood or bone marrow of patients with cancer. With the detection of specific somatic defects in the tumors, a genetic fingerprint of the tumor is determined. This enables to make an accurate diagnosis, to refine a prognosis and/or identify a group of patients for targeted therapy. Targeted therapy is a breakthrough in oncology: for patients in the target group, the response to treatment is most often greater than the response to treatment with non-selective chemotherapy.

The DNA/cfDNA NGS SOLID TUMOR panel and the DNA NGS HEMATO panel are accredited (*) NGS assays, the technique is a DNA-, capture-based massive parallel sequencing. The DNA/cfDNA NGS SOLID TUMOR panel detects single nucleotide variants (SNVs) and indels in 112 genes in samples of solid tumors and sarcomas. The DNA NGS HEMATO panel detects SNVs and indels in 219 genes in samples from hemato-oncological disorders including acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), myeloproliferative disorders (MPN) and chronic lymphoid leukemia (CLL). The MDG-MPN1-mini test (3 genes) is a DNA-based assay that detects SNVs and indels in MPN samples via PCR-based massive parallel sequencing. In addition, an assay is routinely performed for methylation detection of the promoter of the MGMT gene in glioblastoma.

For detection of fusions and splice variants, an accredited (*) RNA NGS assay is available. This is an RNA-, capture-based massive parallel sequencing flow with the RNA NGS PANCANCER panel. The RNA NGS PANCANCER panel includes 175 genes for detection of fusions and splice variants in solid tumors, soft tissue neoplasms and hematological malignancies.

(*) Ghent University, Ghent University Hospital, Center for Medical Genetics is accredited by BELAC under certificate number 351-MED (testing for solid tumors and soft tissue neoplasms) and Ghent University, Ghent University Hospital, Clinical Biology Laboratory is accredited by BELAC under certificate number 087-MED (testing for hematological malignancies).

(1) For the examination of somatic variants in solid tumors and soft tissue neoplasms, the tumor tissue in FFPE should be sent to the Department of Pathological Anatomy UZ Ghent. Here, the FFPE sections are made and the tumor percentage is determined. To do this, use the request form of the Pathological Anatomy department: https://www.uzgent.be/pathologische-onderzoeken-aanvragen --> choose Request form “Aanvraagformulier moleculair pathologisch onderzoek”. The guidelines can be found on the website of the Pathological Anatomy department.

Furthermore, fresh tumor tissue or frozen tumor tissue can also be sent to the laboratory of the Center for medical genetics. Sample instructions: Verworven - Cyto - Centrum Medische Genetica and request form: 'Aanvraagformulier genetisch onderzoek voor maligne cellen (verworven aandoeningen)' (code H9.2-F3).

For certain advanced tumortypes, blood can be sent in PaxGene Blood ccfDNA blood tubes to the Center for medical genetics. Sample instructions: Verworven - MDG - Centrum Medische Genetica and request form: 'Aanvraagformulier cfDNA liquid biopsies van patiënten met solide tumor' (code H9.2-F32).

(2) For the examination of somatic variants in blood or bone marrow of patients with hematological malignancy, send the patient's blood or bone marrow to the Laboratory of clinical biology UZ Ghent, together with a correctly completed request form, found at https://labgids.uzgent.be/, Afdeling Moleculaire Diagnostiek: Hematologie. There you can also find the guidelines and background information (information about the genes under investigation). DNA/RNA isolation and reporting of test results is done by the Laboratory of clinical biology UZ Ghent.

Furthermore, collaborations for clinical trials can be set up with MDG.