Clinical practice guidelines for personalized oncological treatment of the main solid tumors in Colombia

Guía práctica para la personalización del tratamiento oncológico de los principales tumores sólidos en Colombia

Introduction: the constant evolution of tumor genomics is associated with the development of new drugs. In this context, various oncology associations (ASCO, ESMO, NCCN) have developed clinical practice guidelines that offer recommendations on the indications for next-generation sequencing (NGS) to identify therapeutic targets, predictive biomarkers, and prognostics in multiple solid tumors. The rapid expansion of recommendations is due to a greater understanding of the molecular landscape and its applicability in routine clinical practice, even including rare tumors with agnostic alterations.

Methods: this review provides a comprehensive assessment of recommendations on genotyping in cancer, using the classification of genomic alterations according to the Scale for Clinical Actionability of Molecular Targets (ESCAT), as this allows the identification of neoplasms that require complementary molecular biology studies such as NGS, in which clinical benefit has been identified given the possibility of actionable therapies. In this regard, priority was given to presenting Level I information due to the greater evidence for this group of mutations, and it was agreed to report on the presence of genomic alterations with evolving information (Level II) to facilitate the inclusion of subjects in clinical trials and thus promote the development of new drugs.

Results: thirty-four neoplasms with an indication for molecular study and thirty targeted therapies with a level of evidence were included.

Conclusion: requesting molecular studies improves clinical outcomes in the short and medium term.