Exploration of Targeted Anti-tumor Therapy

Table 4. ESCAT tier classification of actionable genes.

Case no.	Primary site	Proposed treatment	Treated	Tier I-A		Tier I-B	Tier II		Tier III				Tier IV		Tier V	Tier X
Case no.	Primary site	Proposed treatment	Treated	*FGFR2*	*IDH1*	*MSI-H/dMMR*	BRAF^V600E	*NTRK*	*HER2*	*BRCA1/2*	*PIK3CA*	*KRAS G12C*	*MET*	*EGFR*	*CTNNB1/WNT*	*TP53/CDKN2A/SMAD4*
1	Vater	Yes	FGFR-I	Yes
2	Distal	Yes	FGFR-I	Yes
3	ICC	Yes	FGFR-I	Yes
4	ICC				Yes											Yes
5	ICC				Yes
6	PHC	Yes	Pem			Yes			Yes
7	PHC	Yes	Pem			Yes					Yes
8	ICC	Yes	Pem			Yes
9	PHC	Yes					Yes									Yes
10	GBC	Yes							Yes							Yes
11	GBC	Yes							Yes							Yes
12	GBC	Yes							Yes							Yes
13	GBC								Yes							Yes
14	GBC	Yes							Yes
15	GBC	Yes							Yes
16	PHC								Yes
17	PHC									Yes						Yes
18	PHC									Yes
19	PHC	Yes								Yes
20	PHC										Yes					Yes
21	Distal															Yes
22	GBC															Yes
23	PHC															Yes
24	Vater															Yes
25	ICC															Yes
26	Distal															Yes
27	GBC															Yes
28	GBC															Yes
29	GBC															Yes
30	Distal															Yes
31	PHC															Yes
32	GBC															Yes
33	PHC															Yes
34	ICC															Yes
35	PHC															Yes
36	Vater															Yes
37	ICC															Yes
38	Distal															Yes
39	PHC															Yes
40	PHC															Yes
41	PHC															Yes
42	GBC															Yes
43	PHC															Yes
44	ICC															Yes
45	Vater															Yes
46	GBC															Yes
47	Distal															Yes

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ESCAT Tiers I‒IV: clinically actionable genomic alterations according to tier; Tier I-A: approved in the same cancer type; Tier I-B: approved in other cancer types; Tiers II‒IV: experimental or emerging evidence; Tier V/X: low or no clinical actionability at present; FGFR-I: fibroblast growth factor receptor inhibitor; Pem: pembrolizumab.

Declarations

Acknowledgments

We would like to thank Editage (www.editage.jp) for the English language editing.

Author contributions

KN: Conceptualization, Investigation, Visualization, Formal analysis, Writing—original draft, Writing—review & editing. MU: Conceptualization, Investigation, Writing—review & editing, Supervision. HS, MI, DD, and SA: Validation, Writing—review & editing. All authors have read and approved the submitted version of the manuscript.

Conflicts of interest

Kei Nakagawa has received lecture fees from Taiho Pharmaceutical Co., Ltd., Insight Co., Ltd., and AstraZeneca Co., Ltd. Shuichi Aoki has received lecture fees from AstraZeneca Co. and Merck & Co., Inc. (Rahway, N.J., USA). Michiaki Unno has received lecture fees from Taiho Pharmaceutical Co., Ltd., AstraZeneca Co., Ltd., and Merck & Co., Inc. (Rahway, N.J., USA). The other authors declare that there are no conflicts of interest.

Ethical approval

This study was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the Ethics Committee of Tohoku University Graduate School of Medicine (2024-1-668).

Consent to participate

Because of the retrospective study design, informed consent was obtained using an institutional opt-out procedure.

Consent to publication

Not applicable.

Availability of data and materials

The datasets for this manuscript are not publicly available because they contain potentially identifiable genomic and clinical patient information and are subject to institutional ethics and privacy restrictions. Requests for accessing the datasets should be directed to Kei Nakagawa (nakagawa.kei@tohoku-mpu.ac.jp).

Funding

No specific funding was received for this study.

Copyright

Publisher’s note

Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.

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