PRecision Oncology Evidence Development in Cancer Treatment - Liquid

The current standard of care for molecular characterization of tumors is tissue based next generation sequencing (NGS) panel. Liquid biopsies (ie blood) are of increasing interest and have been implemented as a diagnostic tool in some countries. This study compares tissue based and liquid based testing to evaluate the detection rate and cost consequence of using this new tool in BC.

Inclusion Criteria: * Age \> 18 * Patients with metastatic malignancy * Patients undergoing tissue based molecular characterization by tissue based NGS panel Part A - Simultaneous * Tissue based NGS panel requested or reported within 4 weeks of enrolment * Patients receiving treatment at BC Cancer Part B - Sequential * Tissue based NGS oncopanel does NOT identify a somatic tier 1 variant of strong clinical significance OR fails/not feasible due to insufficient tissue * BC Cancer - Provincial (not including Vancouver Centre) Exclusion Criteria: * Patients not available for follow up * Patients who are not willing to consider systemic treatment options