Precision oncology based on omics data: The NCT Heidelberg experience.

Area of Science:

• Oncology
• Genomics
• Translational Medicine

Background:

• Precision oncology aims to personalize cancer treatment using molecular diagnostics.
• Next-generation sequencing (NGS) of tumor DNA and RNA identifies actionable genomic alterations.
• Shared genetic alterations across histologies challenge traditional tissue-of-origin treatment paradigms.

Purpose of the Study:

• To describe the MASTER (Molecularly Aided Stratification for Tumor Eradication Research) platform.
• To enable prospective, biology-driven stratification of advanced and rare cancers.
• To guide clinical management through molecular profiling.

Main Methods:

• Standardized workflow for patient selection, consenting, and sample processing.
• Whole-exome/genome and RNA sequencing for comprehensive genomic analysis.
• Bioinformatic analysis, validation of findings, and molecular tumor board evaluation.

Main Results:

• The MASTER platform facilitates categorization of patients into intervention baskets.
• Evidence-based recommendations for clinical management are formulated.
• Demonstrates a clinically applicable approach to precision oncology.

Conclusions:

• Comprehensive molecular analysis and biology-driven stratification are crucial for advanced and rare cancers.
• Future directions include expanding access to molecular profiling and developing genomics-guided clinical trials.
• Moving towards molecular profile-based treatment over tissue of origin is essential.