Introduction/Background The program of the applied precision oncology approach using combined genomic and immunohistochemical (IHC) analyses to develop individual treatment plans in adult patients (pts) with solid tumors has been established in University Hospital Brno since March 2021. We hereby report the results achieved in patients with gynecological tumors.

Methodology Patients undergoing systemic treatment with palliative intent are referred to Molecular Tumor Board (MTB). Whenever possible, the molecular analyses using next-gene sequencing (NGS) together with IHC analyses of key potential targets as requested by the referring physician are performed. The patients whose tumors show an aberration are treated with matched targeted therapy proposed by MTB, when available.

Results Between March 2021 and April 2023, 76 pts with gynecological tumors were referred to MTB; 45 (59%) with ovarian cancer, 15 (20%) uterine cancer, 11 (14%) cervical cancer, 4 (5%) with vaginal/vulvar cancer and 1 (1%) with both ovarian and uterine cancer. Median age at the time of profiling was 59 years, median time from the tumor sampling to profiling was 17 months. Results of profiling were available for 68 tumors with actionable aberrations detected in 49 samples (72%). Based on NGS, actionable genomic signature was found in 13/68 tumors (19%) and gene alterations with targeted therapy available in 30/68 tumors (44%). In total, only 2 samples (3%) did not meet the quality criteria for NGS. By IHC, PDL1 positivity (≥1 either by TPS or CPS) was detected in 32/58 examined tumors (57%), MMR-deficiency in 5/56 tumors (9%) and HER-2 positivity in 2/19 tumors (11%). So far, proposed matched therapy has been started in 16/49 patients (33%) with median time of duration 74.5 days compared to 63.5 days within the prior line of treatment.

Conclusion Combined genomic and immunohistochemical profiling of gynecological tumors is an efficient approach to match patients with targeted therapy.

Disclosures This research was funded by the Ministry of Health of the Czech Republic (MHCR), grant number NU21–03-00306, and MHCR-Development of Research Organization (FNBr, 65269705).