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LeptonXPattern Explorer · Genomic Navigator
ClinicalTrials.gov · connected spark · on-device · 0 cloud
Genomic Navigator

Every marker in your record.
Every therapy, mapped to why.

A living view of your genomic and molecular findings — drawn entirely from your own records, cross-referenced against current research, and organized so the gaps become questions worth asking.

The most important conversations about your health happen between you and your physician. Maya helps you arrive at them prepared.
Behind the navigator your records, resonating with current public research ClinicalTrials.gov v2 API · queried live, no account held
Layer 1 · You
Your record
NGS, FISH & pathology parsed from your own Epic/FHIR data — on your device.
Layer 2 · Public
Trial registry
ClinicalTrials.gov v2 API — queried live for recruiting studies; no account, nothing stored.
Layer 3 · Retrieval
Pattern Explorer
Hybrid dense + BM25 search, reranked & fused — 96.6% retrieval accuracy.
Layer 4 · You
Prepared, not advised
Markers matched to relevant studies — surfaced as questions, never conclusions.
Data source ClinicalTrials.gov · v2 API Surfaced through it NCI Sarcoma Foundation of America SARC Sarcoma Alliance ClinicalTrials.gov is the connected, authoritative registry (public API, no account, nothing stored). The organizations are not separate feeds — their funded and sponsored trials are registered on ClinicalTrials.gov and surfaced by filtering it. NCI is a planned enrichment source.
navigator / patient / timeline / 2026 ◆ on-device · encrypted · yours
MR
Marguerite Rell
Undifferentiated pleomorphic sarcoma (UPS) · pelvis · recurrent
RECORD · EPIC / FHIR
4 molecular reports · 11 tissue specimens
last record sync · today
N/A reason codes · why molecular profiling may not have been pursued on a specimen
R1Low specimen — tumor content too low for reliable testing
R2On active therapy / trial — current treatment already set
R3Recent prior profiling sufficient — adequate data on file
R4Result wouldn't change management — physician judgment
R5Sent to external lab — profiled off this record
Open — question not yet resolved
Set by your physician. A good reason closes the question cleanly; an open specimen that seems like it should have one becomes a precise thing to ask about — not an accusation. R1 on the 2026 specimen is recorded straight from the lab report.
Tissue / specimens on record2020 · diagnostic workup
2020-09-04Pelvis, core needle biopsy — IR-guided→ profiled
Enrolled · active clinical trial on record ON STUDY
SU2C-SARC032 NCT03092323
Neoadjuvant & adjuvant pembrolizumab with radiotherapy and surgery for stage III undifferentiated pleomorphic sarcoma — a randomized phase 2 immunotherapy study.
This is the immunotherapy reflected below: the checkpoint inhibitor (pembrolizumab) Marguerite receives is her trial enrollment. Eligibility here was driven by histology and stage — not by a genomic marker.
Genomic & molecular markers · 4 reports
MDM2
Clinically reported
Amplification
9 copies · high-level gain
FISH / Cytogenetics2020-08-06
Cytogenetics report · MSK
Signed · Ladanyi, M.D. · 2020-08-26
TP53
Validated panel
p.E286K · exon 8
c.856G>A · somatic
MSK-IMPACT 4682020-09-17
MSK-IMPACT 468 report
Signed · Vanderbilt, M.D. · 2020-10-04
CDK4
Investigational
Copy-number gain
6–10 copies · not-for-clinical-use
FISH / Cytogenetics2020-08-06
Cytogenetics report · MSK
Signed · Ladanyi, M.D. · 2020-08-26
RB1
Clinically reported
Deletion w/ 13q34 amp
87% of cells · 19% homozygous
FISH / Cytogenetics2020-08-06
Cytogenetics report · MSK
Signed · Ladanyi, M.D. · 2020-08-26
MSI
Status
Microsatellite stable
MSIsensor 1.3
MSK-IMPACT 4682020-09-17
MSK-IMPACT 468 report
Signed · Vanderbilt, M.D. · 2020-10-04
TMB
Status
2.6 mut/Mb · low
tumor mutational burden
MSK-IMPACT 4682020-09-17
MSK-IMPACT 468 report
Signed · Vanderbilt, M.D. · 2020-10-04
Fusions
Negative
None detected
85-gene panel
Archer FusionPlex2020-08-27
Archer FusionPlex report
Signed · Ross, M.D. · 2020-09-06
Therapies on record · mapped to the markers they address
Medications / targeted
Doxorubicin
CYTOTOXIC · FIRST-LINE · ON RECORD
Understanding-aligned: was this chosen as standard of care, independent of the genomic findings?
— CDK4/6 inhibitor
NOT ON RECORD · MARKER-RELEVANT
Worth asking: given the CDK4 finding, has a CDK4/6-directed approach been considered?
Immunotherapy
Pembrolizumab ON STUDY
CHECKPOINT / PD-1 · VIA SARC032 TRIAL · ON RECORD
Understanding-aligned: my immunotherapy came through a histology/stage trial — do my MSS / low-TMB findings change how its benefit is viewed, or future immunotherapy options?
— MDM2 inhibitor
NOT ON RECORD · ELIGIBILITY QUESTION
Worth asking: my record shows MDM2 amplification and a TP53 mutation — does that affect eligibility?
Tissue / specimens on record2021 · surveillanceN/A — reason (Dr.)
2021-12-29Pelvis — IR needle biopsytissue obtained
2021-03-09Surgical pathology — routinetissue obtained
Each specimen carries an N/A — reason code your physician can set when molecular re-profiling wasn't pursued — often for entirely valid reasons (see legend above). A specimen left open simply means the question hasn't been resolved yet. The aim is to understand where things stand, together — not to flag an omission.
Genomic & molecular markers · 2021
No molecular testing on file for 2021
Tissue was obtained, characterized on surgical pathology — but the record shows no molecular or NGS testing performed on the 2021 specimens.
MDM2 / CDK4
TP53 / RB1
MSI / TMB
Fusions
Tissue / specimens on record2022 · surveillanceN/A — reason (Dr.)
2022-03-24Pelvis — IR needle biopsytissue obtained
2022-02-07Pelvis — IR needle biopsytissue obtained
Each specimen carries an N/A — reason code your physician can set when molecular re-profiling wasn't pursued — often for entirely valid reasons (see legend above). A specimen left open simply means the question hasn't been resolved yet. The aim is to understand where things stand, together — not to flag an omission.
Genomic & molecular markers · 2022
No molecular testing on file for 2022
Two pelvic biopsies were obtained — but the record shows no molecular or NGS testing performed on the 2022 specimens.
MDM2 / CDK4
TP53 / RB1
MSI / TMB
Fusions
Tissue / specimens on record2023 · surveillanceN/A — reason (Dr.)
2023-08-16Surgical pathology — routinetissue obtained
2023-07-12Soft tissue — IR needle biopsytissue obtained
Each specimen carries an N/A — reason code your physician can set when molecular re-profiling wasn't pursued — often for entirely valid reasons (see legend above). A specimen left open simply means the question hasn't been resolved yet. The aim is to understand where things stand, together — not to flag an omission.
Genomic & molecular markers · 2023
No molecular testing on file for 2023
Tissue was obtained on two occasions — but the record shows no molecular or NGS testing performed on the 2023 specimens.
MDM2 / CDK4
TP53 / RB1
MSI / TMB
Fusions
Tissue / specimens on record2024 · surveillanceN/A — reason (Dr.)
2024-10-28Soft tissue — IR needle biopsytissue obtained
2024-08-29Lung / pleura — IR needle biopsytissue obtained
2024-04-04Surgical pathology — routinetissue obtained
Each specimen carries an N/A — reason code your physician can set when molecular re-profiling wasn't pursued — often for entirely valid reasons (see legend above). A specimen left open simply means the question hasn't been resolved yet. The aim is to understand where things stand, together — not to flag an omission.
Genomic & molecular markers · 2024
No molecular testing on file for 2024
Tissue was obtained on three occasions, including a lung biopsy — but the record shows no molecular or NGS testing performed on the 2024 specimens.
MDM2 / CDK4
TP53 / RB1
MSI / TMB
Fusions
Tissue / specimens on record2025 · recurrenceN/A — reason (Dr.)
2025-09-04Pelvis biopsy — "recurrent high-grade sarcoma, consistent with UPS"tissue obtained
2025-09-04Cytology — non-gyntissue obtained
2025-07-28Pelvis — CT-guided biopsy + cytologytissue obtained
Each specimen carries an N/A — reason code your physician can set when molecular re-profiling wasn't pursued — often for entirely valid reasons (see legend above). A specimen left open simply means the question hasn't been resolved yet. The aim is to understand where things stand, together — not to flag an omission.
Genomic & molecular markers · 2025
No molecular testing on file for 2025
The recurrence was confirmed histologically on a pelvis biopsy — but no molecular or NGS profiling of the recurrent tumor appears in the 2025 record. (Re-profiling followed in early 2026 — see the 2026 tab.)
MDM2 / CDK4
TP53 / RB1
MSI / TMB
Fusions
Tissue / specimens on record2026 · currentN/A — reason (Dr.)
2026-04-13Surgical pathology + cytology — most recent tissue on filetissue obtained
2026-02-24Oral cavity, right floor of mouth — biopsytissue obtained
2026-02-23Lung, left mainstem bronchus — endobronchial biopsy → profiled (MSK-IMPACT)profiled
The 2026-02-23 specimen is coded R1 · low specimen straight from the record: the MSK-IMPACT report itself noted low tumor content (≈20% or less) and cautioned that negative copy-number and structural results should be read carefully. Recorded from the report, not inferred.
Genomic & molecular markers · 2026 · re-profiled
SMO
Somatic · detected
p.L23del · exon 1
c.67_69delCTG
MSK-IMPACT (505)2026-02-23
MSK-IMPACT Solid · 505-gene
Signed · Benhamida, M.D. · 2026-03-10
CNAs
Status
None detected
no copy-number alterations · low tumor content caveat
MSK-IMPACT (505)2026-02-23
MSK-IMPACT Solid · 505-gene
Signed · Benhamida, M.D. · 2026-03-10
MSI
Status
Microsatellite stable
MSIsensor 0.11
MSK-IMPACT (505)2026-02-23
MSK-IMPACT Solid · 505-gene
Signed · Benhamida, M.D. · 2026-03-10
TMB
Status
Not evaluable
low tumor content — TMB not reported
MSK-IMPACT (505)2026-02-23
MSK-IMPACT Solid · 505-gene
Signed · Benhamida, M.D. · 2026-03-10
Structural
None detected
No structural variants
low tumor content caveat applies
MSK-IMPACT (505)2026-02-23
MSK-IMPACT Solid · 505-gene
Signed · Benhamida, M.D. · 2026-03-10
Germline
Hereditary panel
Negative
~90 genes · no variant of clinical significance
Secondary Germline IMPACT v42026-02-28
Secondary Germline MSK-IMPACT v4
Signed · Mandelker, M.D. · 2026-03-19
2020 vs 2026 · what the two profiles show
Marker2020 · pelvis2026 · lung
MDM2Amplified · 9 copiesNot detected*
CDK4Gain · 6–10 copiesNot detected*
RB1DeletionNot detected*
TP53Mutation p.E286KNot reported*
SMOMutation p.L23del
MSIMSSMSS
*Critical context, from the 2026 report itself: the 2026 specimen had low tumor content (≈20% or less), and the lab explicitly cautioned that negative copy-number and structural results in low-content samples should be interpreted carefully. So "not detected" in 2026 does not establish that the 2020 markers are gone — it may reflect the sample, not the tumor. The two profiles also sampled different sites (pelvis 2020, lung 2026).
?The question this comparison invites — to understand, together

Two molecular profiles, six years apart, that look different.

The 2020 tumor showed MDM2/CDK4/RB1 alterations; the 2026 sample shows a single SMO mutation and no copy-number changes — but with a low-tumor-content caveat the lab itself raised. That contrast is worth understanding, not interpreting alone.

To bring to the physician

"I can see my 2020 and 2026 molecular results look quite different — the 2020 tumor had MDM2 and CDK4 changes, the 2026 test shows mostly nothing plus a new SMO mutation, and the lab noted low tumor content. Can you help me understand what that difference means — whether it reflects the tumor changing, the sample, or something else — and what it means for my options?"

Eligibility Alignment Engine · how it works

The navigator extracts the data points that drive trial eligibility — tumor type, stage, prior therapy, genomic markers, biomarker status, performance status, age, location — and compares each against a trial's inclusion and exclusion criteria. Each criterion is shown as met, unknown, or possibly disqualifying. We deliberately show no single score or percentage — a number invites false certainty. Instead each trial is placed on a far → close alignment, and the criteria behind it are laid bare so you can see exactly why, and which missing piece would most change the picture.

Screening & preparation only · no eligibility determination · the criteria below — not a score — are what you discuss with your physician & trial coordinator
Marguerite's profile · extracted from record
UPS histology MDM2 amplified '20 CDK4 gain '20 TP53 mutant p.E286K '20 SMO p.L23del '26 MSS · both profiles no fusions stage · current — unknown performance status — unknown 2026 sample low tumor content
Two profiles on file — 2020 (pelvis) and 2026 (lung). The 2026 sample's low tumor content is itself an eligibility-relevant caveat.
Alignment · current recruiting trials — each placed far → close by its own criteria, not by rank
CDK4/6 inhibitor + immunotherapy in sarcoma
NCT06113809 · Phase Ib · recruiting
Closer pending 2 unknowns
FARCLOSE
Tumor type — sarcomaMET
CDK4 alteration (required, high weight)MET
Prior systemic therapyMET
Performance status ECOG 0–1UNKNOWN
CDK4 confirmed on current tissueUNKNOWN
3 met2 unknown0 disqualifying ↳ Resolving: current CDK4 status + ECOG would move this toward a strong match.
MDM2 inhibitor — UPS (Brightline-3)
NCT06370871 · Phase II/III · recruiting
Farther possible exclusion
FARCLOSE
Tumor type — UPS (required)MET
MDM2 amplification (required, high weight)MET
TP53 wild-type (required)CONFLICT
MDM2 confirmed on current tissueUNKNOWN
2 met1 unknown1 possibly disqualifying ↳ Possible exclusion: record shows a TP53 mutation against a TP53-wild-type requirement — but the 2020 status may not reflect the current tumor. A physician/coordinator should weigh this.
Palbociclib + pembrolizumab — sarcoma
NCT06113809-arm · Phase Ib · recruiting
Partial 1 review item
FARCLOSE
Tumor type — sarcomaMET
CDK4 overexpression (preferred)LIKELY
Prior checkpoint exposure (may exclude)REVIEW
Current biopsy for enrollmentUNKNOWN
2 met1 unknown1 review ↳ Prior pembrolizumab (SARC032) may affect a combination-checkpoint arm — a coordinator review item, not an automatic exclusion.
!The single highest-impact data point

The recurring unknown across these trials is now subtler than "no current testing." A 2026 re-profiling does exist — but it found the prior markers not detected on a sample the lab flagged as low tumor content. So the open question is whether the 2020 markers (MDM2, CDK4) still characterize the tumor, or whether the 2026 sample simply couldn't detect them. That single point — confirming the current marker status on adequate tissue — would move several of these matches at once.

The question this engine surfaces

"My 2020 profile showed MDM2 and CDK4 changes that several trials key on; my 2026 profile didn't detect them, but on a low-tumor-content sample. Can we establish whether those markers are still present — so any trial discussion is based on a confident current read rather than a sample-limited one?"

Strong / met Partial / likely Missing information Possible exclusion
?The pattern across the timeline — to understand, together

Profiled in 2020, re-profiled in 2026 — with five surveillance years of biopsies in between.

The record shows molecular profiling at diagnosis (2020) and again in early 2026. In between — 2021 through 2025 — tissue was obtained many times and characterized on surgical pathology, but no molecular or NGS testing appears on those specimens. Step through the year rail above to see it: 2020 profiled, 2021–2025 tissue-only, 2026 re-profiled. This is often entirely appropriate — low tumor content, sufficient prior testing, or no change to management are all valid reasons — which is why each specimen carries an N/A and low-specimen box for the physician. The point is simply for the patient to understand the shape of their own record.

To bring to the physician — to understand, not to challenge

"Looking at my own timeline, I was profiled at diagnosis in 2020 and again in 2026, with several biopsies in the years between that weren't molecularly tested. I'd like to understand that pattern — whether the in-between samples weren't suitable for profiling, and how my 2020 and 2026 results fit together for thinking about options now."

Ask Maya to read this year aloud
Voice · on-device · same record loaded
Clinically reported Investigational use only Measured status Tested · not detected
Provenance. Every marker, specimen, and therapy shown is drawn verbatim from the patient's own medical record. Investigational-vs-clinical labels reproduce the issuing laboratory's own designations. Marguerite Rell is an illustrative patient; the empty later-year tabs reflect a real and common pattern — tissue taken without molecular re-profiling.
What this is — and is not. The Genomic Navigator inventories what the record contains and surfaces what it lacks, cross-referenced against publicly monitored research. It does not diagnose, interpret, prognose, rank therapies, or recommend treatment. Trial references indicate that biomarker-relevant studies exist; eligibility and clinical relevance are determinations for the physician and trial coordinators. Questions are framed to align patient and physician understanding. Markers shown may predate the current tumor.
LeptonX · Intelligence that never leaves your hands. Patent Pending — U.S. Application No. 64/000,111 Read our Principles of Usage →
Source report ×
Report
Signed
Record ID
FHIR ID
In the live app, this opens the full signed pathology document — the exact source this finding was drawn from — rendered from your own record. Nothing is fetched from outside your device. This preview shows the record identifiers the finding is linked to.