29P Sarcoma patients need precision oncology: Is molecular tumor board the right way?

The aim of molecular tumor board (MTB) is to identify potential therapeutic strategies, based on genetic analysis, for patients (pts) not responding standard therapies. All types are eligible MTB discussion and sarcomas one common target due low number innovative treatments. Here we analyze the role in a sarcoma referral center. We presented data from including pts affected by soft tissue (STS) bone (BS) followed at Regina Elena National Cancer Institute Rome discussed Dec 2019 May 2022. 19 STS (14 pts) BS (5 pts). FoundationOne was performed 74%, Archer FusionPlex Sarcoma Panel 37%, DNA Focus Assay 26%, Whole exome sequencing Oncomine Comprehensive Plus 16%, Promega MSI PCR Testing Kit 16% immunohistochemistry PD-L1 pts. Techniques were chosen depending type kit available, cost, alterations searched time obtain results. Druggable targets found 11 pts: mTOR mutation (m), HGF amplification (amp), ATM splice site m, MET amp, KRAS CDK4 MYC PTCH1 PIK3CA MDM4 amp overexpression. Three (16%) received precision therapy: Imatinib everolimus m cordoma, Cabozantinib osteosarcoma Pembrolizumab angiosarcoma with PD-L 1 >10%. Eight continued therapy maintenance response or absence literature supporting treatment (3 Molecular analysis allowed reformulation diagnosis patient presence EWSR1-CREB3L2 fusion, typical low-grade fibromyxoid sarcoma, that led histology-based choice. Four addressed best supportive care (21%) while 2 (10,5 %) died. could be an effective tool decision-making but lack drug access hinder Enrollment clinical trials lead overcome problem. Moreover, timing requesting analyses, end therapies, needs defined, considering both heterogeneity delay obtaining results starting treatment.