Molecular alterations
Laboratory findings that can change the discussion
32 specific alterations are explained separately from their biomarker pages because laboratory reports usually name a specific variant, not only the marker.
EGFR
- DeletionEGFR
EGFR exon 19 deletion
A group of EGFR mutations most often found in non-small-cell lung cancer and commonly discussed when choosing targeted therapy.
Lung cancer
- MutationEGFR
EGFR L858R
A point mutation in exon 21 that, together with exon 19 deletion, is among the most commonly discussed EGFR groups.
Lung cancer
- InsertionEGFR
EGFR exon 20 insertion
A group of EGFR changes that is generally less responsive to usual EGFR inhibitors.
Lung cancer
- MutationEGFR
EGFR T790M
A change that often appears as a resistance mechanism after early-generation EGFR inhibitors.
Lung cancer
- MutationEGFR
EGFR C797S
A change that appears in some patients after third-generation EGFR inhibitor therapy.
Lung cancer
ALK
- FusionALK
ALK fusion (EML4-ALK)
A gene fusion that opens the ALK inhibitor category and is discussed across treatment lines in non-small-cell lung cancer.
Lung cancer
- MutationALK
ALK G1202R
An ALK resistance change commonly discussed after second-generation inhibitors.
Lung cancer
ROS1
- FusionROS1
ROS1 fusion
A rare fusion that opens the ROS1 inhibitor category in non-small-cell lung cancer.
Lung cancer
KRAS
- MutationKRAS
KRAS G12C
A specific KRAS change with dedicated inhibitors, discussed in advanced lung cancer.
Lung cancer, Colorectal cancer
- MutationKRAS
KRAS G12D
A KRAS change commonly found in pancreatic and colorectal cancer, with treatment options still limited.
Pancreatic cancer, Colorectal cancer, Lung cancer
MET
- MutationMET
MET exon 14 skipping
A specific MET change that opens the MET inhibitor category in lung cancer.
Lung cancer
- AmplificationMET
MET amplification
Increased MET gene copy number that can appear as a resistance mechanism to EGFR inhibitors.
Lung cancer, Stomach cancer
RET
- FusionRET
RET fusion
A rare fusion that can be targeted with selective RET inhibitors.
Lung cancer, Stomach cancer
BRAF
- MutationBRAF
BRAF V600E
The most commonly actionable BRAF change, discussed with BRAF and MEK inhibitors.
Lung cancer, Colorectal cancer
ERBB2
- AmplificationHER2
HER2 amplification
Increased HER2 copy number or high protein expression, discussed in stomach and breast cancer.
Stomach cancer, Breast cancer
- OverexpressionHER2
HER2-low
A group with low HER2 expression that is now discussed in some breast cancers.
Breast cancer
NTRK
- FusionNTRK
NTRK fusion
A rare tumour-agnostic fusion that opens the TRK inhibitor category.
Lung cancer, Stomach cancer, Lymphoma
CD274
- Scale statusPD-L1
High PD-L1 TPS (50 percent or more)
A high PD-L1 score in lung cancer that opens discussion of immunotherapy without chemotherapy.
Lung cancer
- Scale statusPD-L1
Low PD-L1 TPS (1 to 49 percent)
A low PD-L1 score that is usually discussed in combination with chemotherapy.
Lung cancer
MMR
- Scale statusMSI / MMR
MSI-high or dMMR
A DNA repair-deficient state that opens an immunotherapy category in several cancers.
Stomach cancer, Colorectal cancer, Breast cancer, Pancreatic cancer
CLDN18
- OverexpressionCLDN18.2
CLDN18.2 positive (75 percent or more, 2+ intensity or higher)
The CLDN18.2 expression threshold used when discussing a specific antibody therapy in stomach cancer.
Stomach cancer
TMB
- Scale statusTMB (tumour mutational burden)
TMB-high
A high tumour mutation burden value sometimes used as an additional consideration for immunotherapy.
Lung cancer, Stomach cancer, Colorectal cancer
TNFRSF17
- ImmunophenotypeBCMA
BCMA positive
BCMA expression on plasma cells, required when discussing anti-BCMA therapy.
Multiple myeloma
GPRC5D
- ImmunophenotypeGPRC5D
GPRC5D positive
An alternative myeloma-cell target for heavily treated disease.
Multiple myeloma
CD19
- ImmunophenotypeCD19
CD19 positive
A B-cell surface marker required for anti-CD19 cellular therapy.
Lymphoma, Leukemia
CD22
- ImmunophenotypeCD22
CD22 positive
A B-cell marker used as a target in some acute lymphoblastic leukemia.
Leukemia, Lymphoma
GPC3
- OverexpressionGPC3
GPC3 positive
GPC3 expression that helps confirm tumour origin and is being studied as a therapy target in liver cancer.
Liver cancer
BRCA1/BRCA2
- MutationBRCA1 / BRCA2
Pathogenic BRCA1 or BRCA2 variant
A pathogenic BRCA change that affects treatment choices and family risk.
Breast cancer, Pancreatic cancer
MGMT
- MethylationMGMT
MGMT methylated
MGMT promoter methylation status discussed in glioma.
Brain cancer
FLT3
BCR-ABL1
- FusionBCR-ABL
Major BCR-ABL transcript (e13a2 or e14a2)
The most common BCR-ABL transcript in chronic myeloid leukemia, used to monitor response.
Leukemia
- MutationBCR-ABL
BCR-ABL T315I
A gatekeeper change that makes most tyrosine kinase inhibitors no longer effective.
Leukemia
Not a diagnosis and not final medical advice. Must be reviewed by a doctor.
Next steps
These suggestions come from links between entries in TanyaKanker's database, not from a medical judgement. Each suggestion includes why it appears.
Next to learn
- Lung Cancer
Cancer type
Reason: Most connected in the oncology graph
- Stomach Cancer
Cancer type
Reason: Most connected in the oncology graph
- Lymphoma
Cancer type
Reason: Most connected in the oncology graph
- Multiple Myeloma
Cancer type
Reason: Most connected in the oncology graph
- ALK
Biomarker
Reason: Highest discovery priority among markers
- BCMA
Biomarker
Reason: Highest discovery priority among markers
- BCR-ABL
Biomarker
Reason: Highest discovery priority among markers
- BRAF
Biomarker
Reason: Highest discovery priority among markers
To check
- Testing Osimertinib as a Treatment for Lung Cancers With an EGFR Exon 20 Change
NCT03191149 - Phase 2
Reason: Registry update in the last 30 days (2026-10-15)
- A Study of Mevrometostat for Treatment of Relapsed/Refractory SCLC, Castration Resistant Prostate Cancer, and Follicular Lymphoma
NCT03460977 - Phase 1
Reason: Registry update in the last 30 days (2026-10-15)
- Testing the Addition of a Type of Drug Called Immunotherapy to the Usual Chemotherapy Treatment for Non-small Cell Lung Cancer, an ALCHEMIST Treatment Trial (Chemo-IO [ACCIO])
NCT04267848 - Phase 3
Reason: Registry update in the last 30 days (2026-10-15)
- Testing the Addition of an Anti-cancer Drug, Lenalidomide, to the Usual Combination Chemotherapy Treatment ("EPOCH") for Adult T-Cell Leukemia-Lymphoma (ATLL)
NCT04301076 - Phase 1
Reason: Registry update in the last 30 days (2026-10-15)
What you can do
- Upload medical reports
Build a case summary in twelve steps
Reason: Often the most useful next step after reading this page
- Request a second opinion
Review of the treatment plan
Reason: Relevant when a treatment plan is being considered
- Consult a navigator
A request is recorded with this page context
Reason: For asking the next step directly
Recently updated
- Testing Osimertinib as a Treatment for Lung Cancers With an EGFR Exon 20 Change
NCT03191149 - Phase 2
Date: Registry update in the last 30 days (2026-10-15)
- A Study of Mevrometostat for Treatment of Relapsed/Refractory SCLC, Castration Resistant Prostate Cancer, and Follicular Lymphoma
NCT03460977 - Phase 1
Date: Registry update in the last 30 days (2026-10-15)
- Testing the Addition of a Type of Drug Called Immunotherapy to the Usual Chemotherapy Treatment for Non-small Cell Lung Cancer, an ALCHEMIST Treatment Trial (Chemo-IO [ACCIO])
NCT04267848 - Phase 3
Date: Registry update in the last 30 days (2026-10-15)
- Testing the Addition of an Anti-cancer Drug, Lenalidomide, to the Usual Combination Chemotherapy Treatment ("EPOCH") for Adult T-Cell Leukemia-Lymphoma (ATLL)
NCT04301076 - Phase 1
Date: Registry update in the last 30 days (2026-10-15)
Want to follow changes on this topic? Save the page or follow the topic so it is easy to find again. View saved items.