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The impact of targeted therapies on molecular alterations identified by an institutional molecular tumor board: an
K Rahmani Narj Abadi1, C Dupain1, I Guillou1
1Department of Drug Development and Innovation (D3i), Institut Curie, Paris, France.
Background:
The European Society of Medical Oncology Scale for Clinical Actionability of Molecular Targets (ESCAT) classification system provides a standardized framework for categorizing genomic alterations (GAs) of patients with recurrent, metastatic, or rare cancer. This study aimed to present outcomes of patients discussed at the molecular tumor board (MTB) in general and according to ESCAT.
Patients And Methods:
We included 1226 patients with recurrent and/or metastatic cancer presented at the MTB from 2018 to 2022. Clinical and demographic data collected included age, gender, type of specimen, tumor type, number of prior treatments received, techniques used for molecular analyses, GAs identified, MTB recommendations, and inclusion or not into a clinical trial. The clinical endpoints collected were overall response rate (ORR), progression-free survival (PFS), and overall survival (OS), and were correlated with ESCAT.
Results:
Successful molecular profiling was carried out in 895 of 1226 (73%) patients. Actionable GAs were found in 595 (49%) patients, and 206 (17%) patients were oriented to matched therapies. Eventually, 101 (8%) patients received a matched therapy. For these patients, PFS and OS were significantly longer for GAs classified as ESCAT tiers I/II, compared with tiers III/IV (P = 0.009 and P = 0.014, respectively).
Conclusions:
Detection of actionable GAs through MTB molecular screening enabled to treat 8% of patients with matched therapy. Patients treated with matched therapy based on ESCAT tiers I/II had statistically longer PFS and OS, compared with ESCAT tiers III/IV.
Insights
The molecular tumor board identified actionable genomic alterations in 49% of cancer patients. Matched therapies based on the European Society of Medical Oncology Scale for Clinical Actionability of Molecular Targets (ESCAT) tiers I/II improved progression-free survival and overall survival.
Area of Science:
- Oncology
- Genomics
- Precision Medicine
Background:
- The European Society of Medical Oncology Scale for Clinical Actionability of Molecular Targets (ESCAT) provides a framework for classifying genomic alterations (GAs) in advanced cancers.
- Molecular tumor boards (MTBs) discuss patient cases to identify potential targeted therapies.
Purpose of the Study:
- To evaluate the outcomes of patients discussed at an MTB.
- To correlate patient outcomes with the ESCAT classification of identified genomic alterations.
Main Methods:
- 1226 patients with recurrent/metastatic cancer discussed at an MTB between 2018-2022 were analyzed.
- Data included demographics, molecular profiling results, MTB recommendations, and clinical outcomes (ORR, PFS, OS).
- Outcomes were correlated with ESCAT classification of genomic alterations.
Main Results:
- Molecular profiling was successful in 73% of patients, identifying actionable GAs in 49%.
- 17% of patients were recommended matched therapies, and 8% received them.
- Patients receiving matched therapy for ESCAT tiers I/II GAs had significantly longer PFS and OS compared to tiers III/IV.
Conclusions:
- MTB molecular screening identified actionable GAs, leading to matched therapy in 8% of patients.
- Matched therapy guided by ESCAT tiers I/II demonstrated superior PFS and OS outcomes.
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