Journal article
A framework to rank genomic alterations as targets for cancer precision medicine: the ESMO Scale for Clinical Actionability of molecular Targets (ESCAT).
- Mateo J Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
- Chakravarty D Memorial Sloan Kettering Cancer Center, New York, USA.
- Dienstmann R Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
- Jezdic S European Society for Medical Oncology, Lugano, Switzerland.
- Gonzalez-Perez A Institute for Research in Biomedicine (IRB), Barcelona.
- Lopez-Bigas N Institute for Research in Biomedicine (IRB), Barcelona; Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.
- Ng CKY University Hospital Basel, Basel, Switzerland.
- Bedard PL Princess Margaret Cancer Centre, Toronto, ON, Canada.
- Tortora G University of Verona, Verona; Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
- Douillard JY European Society for Medical Oncology, Lugano, Switzerland.
- Van Allen EM Harvard Medical School Dana-Farber Cancer Center and Broad Institute, Boston, USA.
- Schultz N Memorial Sloan Kettering Cancer Center, New York, USA.
- Swanton C The Francis Crick Institute, London, UK.
- André F Institut Gustave Roussy, Villejuif, France. Electronic address: education@esmo.org.
- Pusztai L Yale Cancer Center, New Haven, USA.
- 2018-08-24
Published in:
- Annals of oncology : official journal of the European Society for Medical Oncology. - 2018
Antineoplastic Agents
Biomarkers, Tumor
Computational Biology
Consensus
Databases, Genetic
Europe
Genomics
Humans
Medical Oncology
Molecular Targeted Therapy
Neoplasms
Patient Selection
Precision Medicine
Research Design
Societies, Medical
English
Background
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.
Methods
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.
Results
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.
Conclusions
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.
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.
Methods
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.
Results
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.
Conclusions
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.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1093/annonc/mdy263
- PMID 30137196
- Persistent URL
- https://folia.unifr.ch/global/documents/90628
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