In this review:
As we celebrate the first anniversary of Perspectives on Precision Oncology Research Review, we plan to review some of the guidelines that are currently helping to frame the way in which we undertake and utilise the wealth of genomic information that is currently available. As more patients have large panels performed, there is a risk that they may be found to have multiple potentially targetable genomic alterations, with little guidance to suggest the order in which we should select drugs that will target these. This is a particular issue with many of the commercially available somatic tests, which will often list potential drugs that are available in the country in which the testing was undertaken (e.g., USA) alongside any mutations identified. These drugs may not be available or therapeutically beneficial in the tumour type of the patient, leading to confusion or disappointed patients. It is therefore vital to consider ways to apply the available evidence to these alterations to help determine which tests are most important and which results should be prioritised in the treatment pathway. With this in mind, we are starting with the ESMO Scale for Clinical Actionability of molecular Targets (ESCAT).
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