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@ARTICLE{Klostermann:302806,
author = {A. Klostermann and T. Debertshäuser and M. Benary and N.
Biernath and B. Erber and R. Tahbaz and M. Möbs and M.
Joosten and W. D. Schmitt and T. Kim and I. Jelas and L.
Chai and Y. Jegodka and U. Keller and D. Beule and S.
Ochsenreither$^*$ and M. De Santis and T. Schlomm and U.
Keilholz$^*$ and M. Knödler and D. Rieke$^*$},
title = {{I}mplementation and outcome of personalized treatment
strategies in advanced genitourinary cancers.},
journal = {ESMO open},
volume = {10},
number = {7},
issn = {2059-7029},
address = {[London]},
publisher = {Elsevier},
reportid = {DKFZ-2025-01346},
pages = {105497},
year = {2025},
abstract = {Outcome is dismal in patients with advanced genitourinary
(GU) cancers refractory to standard treatments. Molecular
analyses and subsequent discussion of cases in specialized
molecular tumor boards (MTBs) are increasingly incorporated
into clinical management to facilitate personalized
treatment. Data on this approach are lacking for GU
malignancies.We conducted a retrospective analysis of
patients with GU cancers discussed in the MTB at the
Charité between 2016 and 2023. Ethics approval was obtained
for prospective follow-up of patients after written informed
consent and for retrospective data analysis. Clinical
benefit was defined as complete response (CR), partial
response (PR) or stable disease (SD) >6 months or a
progression-free survival (PFS) ratio between molecularly
matched therapy (MMT) and previous non-MMT >1.3. Outcome was
assessed by the investigators.Among 126 identified MTB
patients, most patients had a rare tumor type (n = 59),
followed by adenocarcinoma of the prostate (n = 45),
urothelial carcinoma (n = 17) and clear-cell renal carcinoma
(n = 5). Molecular profiling included immunohistochemistry
(n = 80), panel sequencing (n = 110) and/or
whole-exome/-transcriptome sequencing (n = 21). Eleven
patients died before the final MTB discussion. At least one
treatment option for MMT was identified for 78/115 patients
$(68\%).$ Twenty-five patients were treated with an MMT
$(22\%),$ three of whom subsequently received a second MMT.
Eighteen MMTs were given in an off-label setting and two
within clinical trials. A clinical benefit was observed in
8/28 $(28.6\%)$ applied MMTs. A PFS-ratio >1.3 was achieved
in eight patients. Among patients with rare entities
discussed (n = 54), 42 patients had at least one MMT option
$(78\%),$ with 19 patients receiving at least one MMT
$(35\%).For$ a majority of GU cancer patients an MMT was
identified and responses were seen in heavily pretreated
patients. Additional controlled trials and integration of
comprehensive molecular analyses and subsequent personalized
therapy should be considered for patients with GU cancers,
especially those with rare histologies.},
keywords = {genitourinary cancer (Other) / molecular tumor board
(Other) / precision oncology (Other) / real-world data
(Other) / targeted therapy (Other)},
cin = {BE01},
ddc = {610},
cid = {I:(DE-He78)BE01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:40602108},
doi = {10.1016/j.esmoop.2025.105497},
url = {https://inrepo02.dkfz.de/record/302806},
}