Case studies · For Doctors
Structured support for difficult clinical questions
Composite scenarios that show how a clinician’s question moves through POAS or a Molecular Tumour Board pathway, and what the output can and cannot establish.
Illustrative composite scenarios
These are fictional composites that explain process and potential outputs. They are not real KPCIRC cases, testimonials or clinical or research outcomes.
Illustrative composite case 01
Discordant findings after a change in disease status
- Starting question
- Which of several reported alterations should be prioritised for discussion, now that the disease status has changed?
- Available information
- A molecular report with several alterations, reported variant fractions and specimen notes, plus the current clinical history.
- The challenge or gap
- Variant fractions, specimen context and the clinical history do not align neatly, and the report alone does not resolve which findings matter.
- Relevant KPCIRC pathway
- POAS, with a Molecular Tumour Board considered if multidisciplinary discussion is warranted.
- Analytical or review process
- CloneTrace reviews variant distribution, tumour-content context and any supplied copy-number details. PhenoMap organises biological associations and uncertainty. SynerGX structures therapeutic evidence. Missing technical or clinical details are flagged rather than assumed.
- Intended output
- A structured report separating observations, evidence, limitations and unresolved questions, with specific points for the treating team to verify.
- Limitations and unresolved questions
- The process does not independently validate the original assay and does not establish that any treatment will work.
- Appropriate next action
- The treating clinician reviews the report and decides whether to resolve open questions with the laboratory or request MTB discussion.
Illustrative composite case 02
A biomarker raises a clinical-trial question
- Starting question
- Could a biomarker on the report make the patient a candidate for a specific clinical trial?
- Available information
- A molecular report that appears to match a biomarker described in a trial, and a partial treatment history.
- The challenge or gap
- Prior-treatment requirements, disease setting, protocol exclusions and the participating site are uncertain.
- Relevant KPCIRC pathway
- POAS with emphasis on the TrialGraph layer.
- Analytical or review process
- TrialGraph organises protocol criteria, biomarker context, geography and missing eligibility fields. The team identifies which facts need direct verification with the investigator or site, including recruitment status and current slots.
- Intended output
- A traceable list of potentially relevant trials plus eligibility questions for the treating clinician and trial team.
- Limitations and unresolved questions
- A possible match is not confirmed eligibility, enrolment, a reserved slot or a prediction of benefit.
- Appropriate next action
- The treating clinician contacts the trial team to verify current criteria and recruitment status.
Illustrative composite case 03
A blood-cancer report needs integrated interpretation
- Starting question
- How should multiple findings, including an uncertain variant, be weighed in a haematological malignancy?
- Available information
- A haematology molecular report with several findings and an incomplete clinical context.
- The challenge or gap
- Established observations need to be separated from questions that require further review, and the disease subtype matters to interpretation.
- Relevant KPCIRC pathway
- POAS suitability check, with MTB or haemato-oncology discussion where appropriate.
- Analytical or review process
- The report and the defined question are checked for suitability. Variant and biological context are organised. Therapeutic or trial information is structured only where the disease subtype and evidence support it. Missing information is flagged.
- Intended output
- An evidence summary and a question list for the treating haematologist and relevant multidisciplinary team.
- Limitations and unresolved questions
- Interpretation is disease-specific. Uncertain findings are not promoted to established drivers without sufficient evidence.
- Appropriate next action
- The haematology team considers whether additional testing or discussion is needed.