[Treatment options in rare urological tumors: potential of molecular tumor boards]

Area of Science:

• Urology
• Oncology
• Genomics

Background:

• Rare urological tumors (e.g., neuroendocrine prostate cancer, penile carcinoma) present challenges due to low incidence and heterogeneity.
• Limited evidence-based treatment options exist for these rare malignancies.
• Molecular tumor boards (MTBs) integrate histopathological, genomic, and clinical data for personalized therapy.

Purpose of the Study:

• To review the current molecular approaches for rare urological malignancies.
• To highlight the role of MTBs in identifying therapeutic targets and guiding treatment strategies.
• To emphasize the importance of comprehensive molecular profiling in rare cancer entities.

Main Methods:

• Narrative review of current literature on molecular approaches in rare urological cancers.
• Focus on pathogenesis, clinical characteristics, and systemic treatment strategies.
• Emphasis on the application of MTBs in identifying targets and facilitating experimental treatments.

Main Results:

• MTBs facilitate personalized therapy by integrating multi-omic data.
• MTBs can identify actionable targets in aggressive or refractory rare urological tumors.
• Experimental treatments like antibody-drug conjugates (ADCs) and immune checkpoint inhibitors (ICIs) can be initiated based on MTB recommendations.

Conclusions:

• Comprehensive molecular profiling is essential for rare urological tumors, especially with increasing tumor-agnostic approvals.
• MTBs are crucial tools for optimizing patient care and treatment selection in rare urological malignancies.
• MTBs enable access to novel and experimental therapies, improving outcomes for complex cases.