Actionable alterations
Some alterations have established, approved treatments in a given cancer type. Others have evidence only in other cancers, or only within clinical trials.
Targeted therapy
Treatment directed at a specific molecular alteration.
Targeted therapy depends on identifying a change in the tumour that a drug can act on. Finding an alteration is the beginning of the discussion, not the end of it.
What it involves
How targeted therapy is considered.
Testing that informs it
Tissue-based genomic profiling, targeted panels, immunohistochemistry, FISH and, in selected situations, liquid biopsy contribute to the picture.
Clinical context matters
The same alteration can carry different significance in different cancers, stages and treatment lines. Reports are interpreted, not read literally.
Molecular Tumor Board review
Complex or ambiguous findings benefit from structured multidisciplinary discussion before treatment decisions are made.
Resistance over time
Cancers can adapt, and treatment that works initially may stop working. Repeat assessment or repeat testing is sometimes appropriate.
When no target is found
A report without an actionable finding is still useful information, and standard treatment options and trials remain part of the discussion.
A molecular report does not by itself establish that a targeted treatment is suitable, available or safe for an individual. That assessment requires clinical review.