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Molecular & Genomic Testing

NGS Panels: — What They Test and What They Cost

An NGS panel reads the DNA inside your tumour to find mutations. The cost of that test depends almost entirely on how many genes are included — and wider is not automatically better for your situation.

Medically reviewed by Dr. Mohammed Imaduddin, Surgical Oncologist, MBBS · MS (General Surgery) · M.Ch (Surgical Oncology) · Last reviewed September 2026

  • Tissue, not blood — Most NGS panels use tumour tissue from a biopsy you have already had, not a new blood draw.
  • Two main types — Small panels cover a defined set of genes; comprehensive panels cover hundreds.
  • Cost follows scope — Wider panels cost significantly more, but the extra cost only delivers value if more genes are relevant to your treatment decision.
  • Oncologist decides — The right panel depends on your cancer type, your stage, and where you are in treatment.
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An NGS panel sequences DNA from your tumour tissue to find mutations. Small panels test a defined set of genes relevant to your cancer type and cost less. Comprehensive panels test hundreds of genes and cost significantly more. Which type you need — and whether you need either — is your oncologist's decision, based on your cancer and treatment situation.

What does an NGS panel actually sequence?

An NGS panel takes DNA from your tumour biopsy and reads it to find mutations — changes in the genes driving the cancer's growth. Most panels use tissue from a biopsy you have already had; a fresh sample is only needed if the original was too small.

The test reads many genes at once in a single laboratory run. That is what makes it different from older tests, which could check only one mutation at a time.

What do the terms in your NGS report mean?

NGS (Next Generation Sequencing)
A technology that reads many sections of DNA simultaneously. In cancer care, it maps mutations in tumour tissue to guide treatment decisions.
Gene panel
A fixed list of genes the test will check. A small panel may cover fewer than 50 genes; a comprehensive panel may cover 300 or more.
Somatic mutation
A change in the DNA that arose in the tumour itself, not inherited from your parents. Most NGS panels in cancer look for somatic mutations.
Actionable mutation
A mutation for which a matched treatment exists and is available to you today. Not every mutation a panel finds is actionable.
Variant of uncertain significance (VUS)
A change in the DNA that has been found but whose effect on the cancer is not yet understood. A VUS does not currently guide treatment.
Comprehensive genomic profiling (CGP)
A type of NGS that covers a very large number of genes — typically 300 or more — and includes additional markers such as tumour mutational burden.
Tumour mutational burden (TMB)
A measure of how many mutations are present across the tumour overall. Some treatments are guided by TMB as well as by individual gene mutations.

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Small panel or comprehensive — which gives more value for your money?

A small panel is built around what is already established for your cancer type. For many common cancers, the mutations that matter are well understood, and a focused panel finds them reliably at lower cost.

A comprehensive panel is most useful when standard options have been exhausted, when the tumour is rare or has behaved unexpectedly, or when a clinical trial requires a specific mutation to be confirmed.

The figure that matters is actionable yield — mutations for which a treatment is available to you in India today. A report listing many mutations, most without a matched treatment, does not deliver proportionally more value. Ask your oncologist what proportion of results from the recommended panel are typically actionable for your cancer type before you pay.

How do a small panel and a comprehensive panel compare?

Small or targeted panelComprehensive genomic profiling (CGP)
Genes coveredTypically fewer than 50, chosen for your cancer typeTypically 300 or more, including rare and emerging targets
When usually orderedFirst-line molecular testing for common cancers with established driversStandard options exhausted, rare tumours, or clinical trial eligibility
TurnaroundUsually one to two weeksOften two to four weeks; longer if processed abroad
Relative cost (indicative, 2025–26)LowerSubstantially higher — sometimes several times the cost of a small panel
Actionable result rateHigh for cancers with well-known driver mutationsBroader absolute yield; many findings may be VUS or lack a matched treatment today
Risk of missing a key mutationHigher if the mutation falls outside the panel's fixed scopeLower, though no panel sequences the entire genome

Before you pay for NGS testing, confirm these things

  • Your oncologist has recommended this specific test — not just genomic testing in general.
  • Your tumour tissue from the biopsy is available and sufficient for the panel being ordered.
  • You know whether the laboratory is NABL-accredited or holds equivalent quality certification.
  • You understand that finding a mutation does not guarantee a matched treatment is available in India.
  • You have asked how the report will be reviewed — ideally by an oncologist experienced in molecular tumour board interpretation.
  • You have asked whether the cost qualifies for any government scheme, insurer pre-authorisation, or compassionate-access pathway.

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Common questions

Frequently asked questions

How much does an NGS panel cost in India?

Costs vary widely between panel types and laboratories, and change frequently — any figure stated here would be outdated quickly. Small targeted panels cost significantly less than comprehensive genomic profiling, which can cost several times more. The right comparison is between panel types, not between laboratories. Ask your oncologist which type is indicated for your cancer, then ask the laboratory for a written quote before committing. Confirm what is included: interpretation, reporting, and tumour board review are not always bundled into the base price.

Is NGS the same as FISH or IHC testing?

No. FISH and IHC are older single-marker tests that check for one specific change at a time. NGS reads many genes simultaneously in a single run. For some cancers and markers, FISH or IHC remains the recommended test because the evidence behind it is more established. NGS is not automatically superior — it is a different tool. Your oncologist will recommend whichever test the evidence supports for your specific situation.

Does a comprehensive panel mean better treatment?

Not necessarily. A comprehensive panel finds more mutations, but many findings may be variants without a currently available matched treatment. Better treatment follows from finding a mutation that has an effective treatment behind it — not from a longer report. For many patients, the right small panel finds exactly what is needed at lower cost and in less time. NCCN and ESMO guidance both recommend test selection based on clinical indication, not panel breadth.

Can NGS be done from a blood test?

A blood-based version called a liquid biopsy exists. It analyses DNA shed by tumour cells into the bloodstream and is useful when tissue is unavailable or when monitoring how a tumour is changing over time. It is not interchangeable with tissue NGS — it is less sensitive and may miss mutations a tissue panel would find. Your oncologist will advise whether tissue, blood, or both are appropriate for your situation.

Is NGS testing covered by health insurance in India?

Coverage varies by insurer and policy. Some plans cover NGS when ordered for specific indications and accompanied by a treating oncologist's recommendation. Pre-authorisation before the test is almost always required — a claim submitted after testing is far harder to approve than one approved in advance. Ask your insurer in writing, providing your oncologist's letter of recommendation, before the sample is sent to the laboratory.

What does it mean if my report says 'variant of uncertain significance'?

It means a change was found in the DNA but its effect on the cancer is not yet understood. A VUS does not currently guide treatment — it is not dangerous, but it is not actionable either. Your oncologist will explain whether the specific VUS in your report is worth monitoring as new evidence emerges, or whether it can be set aside. VUS classifications are updated regularly as more data becomes available, so a finding classified as uncertain today may be reclassified in future.

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