Delivering Precision Oncology at Scale—Infrastructure, Evidence, and the Path Forward
Menée à partir de données portant sur 3 383 patients atteints d'une tumeur solide rare, de stade avancé et réfractaire aux traitements (âge moyen : 57,1 ans ; 53 % de femmes ; durée de suivi maximale : 6 ans), cette étude multicentrique évalue l'intérêt, du point de vue de l'amélioration de la survie globale, d'adapter les thérapies en fonction du profil génomique de la tumeur
In their study in this issue of JAMA Oncology, Lin and colleagues report findings from Australia’s Molecular Screening and Therapeutic (MoST) program. This cohort study examined 3383 patients with advanced, refractory cancers who underwent comprehensive genomic profiling. Using the Therapy-Oriented Precision Oncology Guidelines for Recommending Anticancer Pharmaceuticals (TOPOGRAPH) framework to stratify biomarker-drug pairs by evidence strength, the authors found that 37.5% of patients had clinically active biomarkers (tiers 1-3A). Patients receiving therapies matched to these biomarkers showed considerably improved survival compared to unmatched therapy (21.2 months vs 12.8 months; 40% reduced death risk). However, therapies matched using only preclinical evidence or repurposed from other cancer types showed no survival benefit. The authors conclude that genomically guided therapy is associated with improved outcomes only when supported by prospective clinical trial evidence, emphasizing the importance of evidence-based frameworks in precision oncology.
JAMA Oncology , éditorial, 2026