Treatment Guided by Comprehensive Genome and Transcriptome Analysis Versus Standard of Care in Advanced Rare Cancers

To be considered for this study, you need to be at least 18 years old and have an advanced rare cancer (either epithelial or mesenchymal type) that has spread or is locally advanced. Your cancer should be getting worse or expected to get worse, and you should have already tried at least one standard treatment, or there isn't a standard treatment available for your specific type of cancer.

It's important that we can get a small sample of your tumor tissue (a biopsy) or use a recent sample taken within the last three months. You also need to be generally well enough to take part in the study, meaning you are able to carry out most daily activities without too much help. You must be able to understand what the study involves and be willing to consider the treatment recommendations that come from the genetic testing.

There are also some reasons why you might not be able to join. For example, if you have severe memory problems, epilepsy that needs medication, or have had a bone marrow or organ transplant in the past. People with blood cancers (like leukaemia) or primary brain tumours are also not included. If your cancer has spread to your brain or spinal cord and is causing severe symptoms, you might not be eligible unless it's been successfully treated and isn't causing problems anymore.

If you join this study, you'll first have detailed genetic tests done on your cancer tissue. You'll then be randomly assigned to one of two groups. One group will start treatment based on these genetic results right away. The other group will receive standard care first, with the option to switch to genetically guided treatment later if needed. The specific treatments you receive will depend on your cancer's genetic make-up and what your doctors recommend.

Throughout the study, you'll have regular appointments for check-ups, scans (like CT or MRI), and blood tests to monitor your cancer and your overall health. You'll also be asked to complete questionnaires about how you're feeling and your quality of life. The exact duration of your participation will depend on how your treatment progresses, but the study will regularly assess how well the treatments are working and how you are coping. The total duration for individual patients is not universally fixed but will be guided by treatment response and patient wellbeing.