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Hoe werkt OncoAct?

Whole genome sequencing

OncoAct uses whole genome sequencing which makes it possible to read the complete DNA of the tumour tissue and blood.

Human DNA, also called the genome, consists of 2×3 billion “letters” (one copy from your mother and one from your father) and is present in every somatic cell. This DNA contains all the information necessary for a cell, tissue, and organism to function and for cells to divide.

Coincidental and environmental factors can damage the DNA. This can change the properties of a cell and cause cancer. For a good understanding and optimal treatment of a tumour, it is therefore important to have a high resolution “photo” of the damaged DNA from the tumour.

DNA damage occurs in all kinds of ways. It may be that some DNA letters have changed, but also that small or large pieces of DNA have disappeared or doubled. DNA can also break down and be repaired in the wrong way by the body, after which it ends up in another place in the genome.

Whole genome sequencing can be used to track all types of changes. To ensure that the changes measured are mutations that only occur in the tumour, the DNA of the tumour is always compared with the “normal” DNA of the patient. For this we use DNA from the blood.


After an extensive bioinformatic data analysis, we examine which existing and experimental treatments match the characteristics (biomarkers) of the tumour, both for registered and off-label indications. We use global knowledge gathered in specialised databases and overviews of ongoing research in the Netherlands to do this.

All relevant molecular data and treatment options are summarised in the OncoAct patient report. This gives the treating physician as complete an overview as possible of the cancer-related DNA mutations in the patient.

The patient report contains the following detailed information:

  • algemene samenvatting met relevant klinisch bewijs

  • beschikbare medicijnen die mogelijk aansluiten bij de gevonden DNA-afwijkingen

  • uitgebreide moleculaire details ter ondersteuning van een behandelkeuze

The patient report also provides insight into:

  • tumorspecifieke mutaties, amplificaties, deleties

  • mutational load / mutational burden

  • microsatelliet instabiliteit

  • aanwezigheid van fusiegenen als gevolg van translocaties

  • mogelijkheid voor deelname aan klinische studies in Nederland

The summary contains an overview of genes with potential actionable mutations and various general tumour characteristics, such as microsatellite instability (MSI) and tumour mutational load (TML). These characteristics are important for immunotherapy options.

Click here for an example of the patient report.

Wat vindt u in het patiëntrapport?

De resultaten van alle bestaande DNA-testen in één rapport

Wat vindt u in het patiëntrapport?

Een samenvatting van de uitkomsten die relevant zijn voor een mogelijke behandeling

Wat vindt u in het patiëntrapport?

Een uitgebreide weergave van alle veranderingen in het erfelijk materiaal (mutaties)

Wat vindt u in het patiëntrapport?

Uitkomsten die altijd getoetst zijn aan de meest recente wetenschappelijke inzichten

Hoe helpt het u?

Het rapport ondersteunt de keuze voor behandeling

  • reguliere behandelingen

  • beschikbare experimentele studies

  • off-label medicatie

Voordelen van een DNA-test op basis van whole genome sequencing

Alle mogelijke biomarkers

Alle mogelijke DNA-gebaseerde biomarkers worden in één DNA-test bepaald

Eén patiëntrapport

Alle resultaten en uitslagen worden in één patiëntrapport samengevat

Eén overzicht

Relevante resultaten met mogelijke behandelopties worden in één overzicht samengevat


Patiënten geanalyseerd

In recent years, we have analysed more than 4,500 patients with metastatic cancer using whole genome sequencing.

The number of results that may be relevant for treatment varies greatly between cancer types.


Aanknopingspunten voor bestaand medicijn

On average, we found indicators for treatment with existing medication for 31% of patients.



In 13% of these patients, this is medication that is actually registered for another tumour type (off-label)*.

* published in Nature, November 2019


Experimentele medicijnen

For approximately 31% of patients we also found indications for using experimental medication. Access to these medications is possible through clinical trials.


Off-label behandeling

A recent study shows that 34% of patients benefit from off-label treatment in clinical trials.*

* published in Nature, September 2019


Behandeladvies naar aanleiding van uitgebreide DNA-analyses bij patiënten in de afgelopen 4 jaar

  • standaard behandeling
  • off-label behandeling
  • experimentele behandeling
  • geen behandeladvies / geen aanknopingspunten voor behandeling, soms zijn er nog studies open


It is important for the patient and the treating physician to know the results of OncoAct quickly.
In general, we send a patient report to the treating physician 10 to 15 working days after receiving the tumour tissue and blood.

Werkzaamheden tijdens de DNA-test

The tumour tissue and blood are immediately scheduled for processing after receipt and registration. Processing the tumour tissue and blood consists of a number of labour-intensive steps, each of which takes one day or more: DNA isolation, sample preparation, DNA sequencing, and bioinformatic data analysis. We conduct quality checks after each step. If the tumour tissue contains sufficient tumour cells and the DNA is of sufficient quality, we perform the test and can report the results. If this is not the case, we do not produce a patient report.

Validatie van de DNA-test

OncoAct is performed according to standardised procedures in the ISO17025 accredited laboratory of Hartwig Medical Foundation in Amsterdam. The methods used and test results have been extensively validated. You can request these by e-mail.