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      A framework to rank genomic alterations as targets for cancer precision medicine: the ESMO Scale for Clinical Actionability of molecular Targets (ESCAT)

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          Abstract

          <div class="section"> <a class="named-anchor" id="s1"> <!-- named anchor --> </a> <h5 class="section-title" id="d4855607e293">Background</h5> <p id="d4855607e295">In order to facilitate implementation of precision medicine in clinical management of cancer, there is a need to harmonise and standardise the reporting and interpretation of clinically relevant genomics data. </p> </div><div class="section"> <a class="named-anchor" id="s2"> <!-- named anchor --> </a> <h5 class="section-title" id="d4855607e298">Methods</h5> <p id="d4855607e300">The European Society for Medical Oncology (ESMO) Translational Research and Precision Medicine Working Group (TR and PM WG) launched a collaborative project to propose a classification system for molecular aberrations based on the evidence available supporting their value as clinical targets. A group of experts from several institutions was assembled to review available evidence, reach a consensus on grading criteria and present a classification system. This was then reviewed, amended and finally approved by the ESMO TR and PM WG and the ESMO leadership. </p> </div><div class="section"> <a class="named-anchor" id="s3"> <!-- named anchor --> </a> <h5 class="section-title" id="d4855607e303">Results</h5> <p id="d4855607e305">This first version of the ESMO Scale of Clinical Actionability for molecular Targets (ESCAT) defines six levels of clinical evidence for molecular targets according to the implications for patient management: tier I, targets ready for implementation in routine clinical decisions; tier II, investigational targets that likely define a patient population that benefits from a targeted drug but additional data are needed; tier III, clinical benefit previously demonstrated in other tumour types or for similar molecular targets; tier IV, preclinical evidence of actionability; tier V, evidence supporting co-targeting approaches; and tier X, lack of evidence for actionability. </p> </div><div class="section"> <a class="named-anchor" id="s4"> <!-- named anchor --> </a> <h5 class="section-title" id="d4855607e308">Conclusions</h5> <p id="d4855607e310">The ESCAT defines clinical evidence-based criteria to prioritise genomic alterations as markers to select patients for targeted therapies. This classification system aims to offer a common language for all the relevant stakeholders in cancer medicine and drug development. </p> </div>

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          Author and article information

          Journal
          Annals of Oncology
          Oxford University Press (OUP)
          0923-7534
          1569-8041
          August 21 2018
          August 21 2018
          Affiliations
          [1 ]Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
          [2 ]Memorial Sloan Kettering Cancer Center, New York, USA
          [3 ]European Society for Medical Oncology, Lugano, Switzerland
          [4 ]Institute for Research in Biomedicine (IRB), Barcelona
          [5 ]Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
          [6 ]University Hospital Basel, Basel, Switzerland
          [7 ]Princess Margaret Cancer Centre, Toronto, ON, Canada
          [8 ]University of Verona, Verona
          [9 ]Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
          [10 ]Harvard Medical School Dana-Farber Cancer Center and Broad Institute, Boston, USA
          [11 ]The Francis Crick Institute, London, UK
          [12 ]Institut Gustave Roussy, Villejuif, France
          [13 ]Yale Cancer Center, New Haven, USA
          Article
          10.1093/annonc/mdy263
          6158764
          30137196
          5ac775e0-c28d-48ad-942c-dba2e69fda49
          © 2018

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