Targeted therapy guided by genomic profiling and a molecular tumor board improves outcomes in pretreated metastatic cancer patients.

In a randomised, multi-basket, phase II, Italian multicentre ROME study conducted among pretreated patients with metastatic cancer, targeted therapy, driven by comprehensive genomic profiling and molecular tumour board (MTB) activities, significantly improved overall response rate (ORR) and progression-free survival (PFS), with a notable long-term PFS benefit at 12 months and beyond. However, targeted therapy was not associated with overall survival (OS) benefit. In a high tumour mutational burden (TMB) subgroup, immunotherapy provided a significant PFS benefit among patients with both microsatellite instability (MSI)-high and microsatellite stable (MSS) tumours.