Precision medicine at Memorial Sloan Kettering Cancer Center: clinical next-generation sequencing enabling next-generation targeted therapy trials

• Comprehensive precision medicine strategies require a comprehensive multidisciplinary approach.
• Screening assays must be sufficiently broad to identify the full landscape of actionable genomic alterations.
• Profiling must be applied broadly, irrespective of whether molecular testing is required to guide standard-of-care therapy.
• Multi-histology biomarker-selected ‘basket’ studies support treatment based on identified actionable alterations.

Implementing a center-wide precision medicine strategy at a major cancer center is a true multidisciplinary effort and requires comprehensive alignment of a broad screening strategy with a clinical research enterprise that can use these data to accelerate development of new treatments. Here, we describe the genomic screening approach at Memorial Sloan Kettering Cancer Center, a hybridization capture-based next-generation sequencing clinical assay for solid tumor molecular oncology designated MSK-IMPACT, and how it enables and supports a large clinical trial portfolio enriched for multi-histology, biomarker-selected, ‘basket’ studies of targeted therapies.