A new scale for tumor DNA mutations which will simplify and standardize choices for targeted cancer treatment has been agreed upon by leading cancer specialists in Europe and North America. The scale, called ESCAT (ESMO Scale for Clinical Actionability of Molecular Targets), was published online on August 21, 2018 in the Annals of Oncology. The ESMO is the European Society for Medical Oncology. The new scale aims to optimize patient care by making it easier to identify patients with cancer who are likely to respond to precision medicines, and help make treatment more cost-effective. "Doctors receive a growing amount of information about the genetic make-up of each patient's cancer, but this can be difficult to interpret for making optimal treatment choices," explains Professor Fabrice André, Chair of the ESMO Translational Research and Precision Medicine Working Group who initiated this project. "The new scale will help us distinguish between alterations in tumor DNA that are important for decisions about targeted medicines or access to clinical trials, and those which aren't relevant."The new grading system classes alterations in tumor DNA according to their relevance as markers for selecting patients for targeted treatment, based on the strength of clinical evidence supporting them (Tier I-V, Table 1). It is the first time that a classification has been developed that is relevant to all potential targeted cancer medicines, not just those that have been approved for use by national regulatory bodies. The classification also enables mutations to be upgraded or downgraded in response to newly available data.
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