Actionability
Diagnostic
A single table in the biomarker details provides a list of all the diagnostic assertions from all included sources that have content about the biomarker (e.g., My Knowledge Base).
You can filter by other diseases or by summary. When filtering by summary for guideline evidence, specify the website (for example, ESMO.org or NCCN.org).
Filter changes are saved and applied across variants within a case and can be reset if needed.
Therapeutic, Prognostic
A single table in the biomarker details provides a list of all the therapeutic and prognostic assertions from all included sources that have content about the biomarker (e.g., My Knowledge Base).
By default, the assertions are filtered by the case and ancestor diseases. Ancestor diseases are determined using SNOMEDCT. These diseases can be viewed at the SNOMED CT Browser website, with the following exceptions:
Descendents of neoplastic disease do not include ancestors beyond neoplastic disease.
Non-small cell lung cancer has been added as an ancestor of adenocarcinoma of lung.
You can filter by other diseases, by summary, or by approval. When filtering by summary for guideline evidence, specify the website (for example, ESMO.org or NCCN.org).
Filter changes are saved and applied across variants within a case and can be reset if needed.
Actionability Legend
Field Name
Description
Column
Description
Published Date
The date that the assertion was updated.
Source
Knowledge base origin of the assertion.
Biomarker
Indicates whether an assertion is the nucleotide, annotation overlap, partial fusion, amino acid,codon, exon, or gene level. This column is only available for variants.
Status
Indicates the TMB, MSI, or GIS status for the assertion. This column is available for TMB, MSI, and GIS.
HRD
Indicates whether an assertion is associated with HRD positive or negative. This column is available for GIS and variants when the selected transcript is for BRCA1/2.
Classification
This column displays the classification (for example, Tier 1A), as indicated by the knowledge base.
Type
Therapeutic, Diagnostic, or Prognostic as indicated by the knowledge base.
Direction
• For therapeutic; responsive, nonresponsive, etc., as indicated by the knowledge base. • For prognostic; favorable, unfavorable, etc., as indicated by the knowledge base.
Therapy
Therapy for the assertion.
Disease
Disease for the assertion.
Approval
Authorities that have approved the therapy for the biomarker and disease. • CKB provides FDA, EMA, ANVISA, PDMA, and TGA approvals. • OncoKB level 1 assertions are annotated with FDA.
Actions
Available Knowledge Bases
Memorial Sloan Kettering OncoKB
Connected Insights provides the Memorial Sloan Kettering OncoKB. For more information, refer to the OncoKB website.
The following from OncoKB are not supported:
Non-compliant HGVS
Unspecified positions: Epigenetic Silencing, ARv567es, AR-V7, DNMT3B7, vIII, vII, vV, TGFBR1*6A, Overexpression, Wildtype, Promoter Hypermethylation, Hypermethylation, Kinase Domain Duplication, Internal Tandem Duplication, Partial Tandem Duplication
Jackson Clinical Knowledge Base (JAX-CKB)
Connected Insights provides the Jackson Clinical Knowledge Base (JAX-CKB). For more information, refer to the Jackson CKB website.
The following from JAX-CKB are not supported:
Complex molecular profiles (for example, co-occuring biomarker assertions)
Emerging and risk factor evidence types
Class #, over exp, dec exp, hypermethylation, hypomethylation, dup exonX, dup exonX-X, LOH, loss, negative (except for HRD andMSI), positive (except for HRD), and wild type variants.
Clinical Interpretation of Variants in Cancer (CIViC)
Connected Insights also provides the Clinical Interpretation of Variants in Cancer (CIViC) knowledge base. For more information, refer to the CIViC website.
The following from CIViC are not supported:
Assertions
Functional and oncogenic evidence types
Splice Site (c.3028G>A), Boolean-like evidence (for example, (V600E or V600K) and Amplification), Underexpression, Overexpression, Expression, Decreased Peri-therapeutic Expression, Cytoplasmic Expression, Loss, Biallelic Inactivation, Alu Insertion, Alternative Transcript, RSID, Homozygosity, Copy-neutral Loss of Heterozygosity, Cytoplasmic Mislocation, Deleterious Mutation, Double Ph, Wildtype, Domain, Exon-specific fusions
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