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Review
. 2025 Sep 23:216:104960.
doi: 10.1016/j.critrevonc.2025.104960. Online ahead of print.

Extended molecular profiling in mesenchymal tumors: a consensus paper from the Italian Sarcoma Group

Lorenzo D'Ambrosio  1 Marta Sbaraglia  2 Alessandra Merlini  3 Martina Rabino  4 Giovanni Grignani  5 Viviana Appolloni  6 Giuseppe Badalamenti  7 Giacomo Giulio Baldi  8 Elena Bellan  2 Matteo Benelli  9 Alexia Francesca Bertuzzi  10 Roberto Biagini  11 Giuseppe Bianchi  12 Antonella Boglione  13 Antonella Brunello  14 Domenico Andrea Campanacci  15 Ferdinando Cananzi  16 Paolo Giovanni Casali  17 Beatrice Casini  18 Marilena Cesari  19 Benedetta Chiusole  14 Camilla Cristalli  20 Alessandro De Vita  21 Elena Di Blasi  22 Franca Fagioli  23 Valentina Fausti  24 Virginia Ferraresi  25 Anna Maria Frezza  26 Elena Fumagalli  26 Marco Gambarotti  27 Claudia Giani  17 Alessandro Gronchi  28 Massimiliano Grassi  29 Toni Ibrahim  19 Andrei Ivanescu  30 Gianluca Ignazzi  6 Lorena Incorvaia  7 Alessandra Linari  31 Roberto Luksch  32 Andrea Marrari  19 Alessandro Mazzocca  33 Giuseppe Maria Milano  34 Carlo Morosi  35 Margherita Nannini  36 Pierina Navarria  37 Elena Palassini  26 Emanuela Palmerini  38 Fiammetta Paloschi  39 Maria Abbondanza Pantaleo  36 Sandro Pasquali  40 Valeria Pavese  4 Enrico Pozzo  37 Vittorio Quagliuolo  41 Michela Quirino  42 Roberta Sanfilippo  26 Federica Santoro  31 Katia Scotlandi  20 Massimo Serra  27 Elisabetta Setola  43 Sabino Strippoli  44 Salvatore Tafuto  45 Elisa Tirtei  23 Silvia Vanni  21 Bruno Vincenzi  33 Roberta Maestro  46 Angelo Paolo Dei Tos  2 Silvia Stacchiotti  26
Affiliations
Free article
Review

Extended molecular profiling in mesenchymal tumors: a consensus paper from the Italian Sarcoma Group

Lorenzo D'Ambrosio et al. Crit Rev Oncol Hematol. .
Free article

Abstract

Extended molecular profiling using massive parallel sequencing (MPS) technologies, commonly referred to as next-generation sequencing (NGS), has revolutionized cancer diagnosis and treatment, including in bone and soft tissue sarcomas (BSTS). This heterogeneous group of mesenchymal tumors presents a complex spectrum of genetic alterations, such as chromosomal rearrangements, point mutations, and copy number variations. Unlike carcinomas, where driver mutations are often well defined, the role of specific genomic signatures in dictating BSTS prognosis and therapy response remains to be fully elucidated. Despite its promise, the adoption of MPS/NGS in BSTS is limited by variability in testing access, turnaround times, specimen quality, costs, and data interpretation. Although identified alterations are often not yet directly targetable, they provide critical insights that can refine diagnosis, enable better patient stratification, and guide treatment strategies. To optimize the use of MPS/NGS in BSTS, harmonization and multidisciplinary collaboration within molecular tumor boards (MTBs) are essential. With this aim, the Italian Sarcoma Group ETS (ISG) convened a consensus meeting to establish best practices for integrating MPS/NGS into everyday clinical care. ISG experts developed ten consensus statements: the first five address the role of extended molecular profiling in BSTS diagnostics, while the others offer guidance on MPS/NGS use and interpretation when searching for potentially actionable targets in the treatment of advanced disease. Furthermore, collaboration with the National Rare Cancer Network to offer expert consultation and systematically correlate MPS/NGS findings with clinical outcomes for BSTS cases undergoing extended molecular profiling will be critical to advancing precision medicine in this field.

Keywords: Bone tumors; GIST; Massive parallel sequencing; Next generation sequencing; Sarcoma.

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Conflict of interest statement

Declaration of Competing Interest All authors reported no conflict of interest (COI) for the present work. Outside the submitted work the following authors reported potential COIs: The Author Lorenzo D’Ambrosio reports the following COIs: Advisory role: PSI CRO Italy, Boerhinger Ingelheim, GSK, Eisai Co Ltd, and AstraZeneca Meeting participation: PharmaMar, Gentili, and Amgen Inc The Author Alessandra Merlini reports the following COIs: Grant (institutional): PharmaMar The Author Giovanni Grignani reports the following COIs: Grants and personal fees from PharmaMar, grants from Novartis, and personal consulting fees from Lilly, Pfizer, Bayer, and Eisai. The Author Giacomo Giulio Baldi reports the following COI: Advisory role: Pharmamar, Eli Lilly, Glaxo Smith Kline, Merck Sharp & Dome, Deciphera Consulting fees: Eli Lilly, Pharmamar Honoraria: Pharmamar, Eli Lilly, Glaxo Smith Kline, Merck Sharp & Dome, Istituto Gentili Travel grants: Istituto Gentili, Pharmamar, Eli Lilly The Author Domenico Andrea Campanacci reports the following COI: Link Italia; Adler Ortho The Author Elena Fumagalli reports the following COI: Consulting or Advisory Role: Deciphera PharmaceuticalsResearch Funding: Deciphera Pharmaceuticals (Inst), Blueprint Medicines (Inst), Cogent Biosciences (Inst), IDRX, Inc. (Inst.), GlaxoSmithKline (Inst), Novartis (Inst), PharmaMar (Inst), Eisai (Inst), Lilly (Inst), Advenchen Laboratories (Inst), Epizyme Inc. (Inst), Karyopharm Therapeutics (Inst), SpringWorks Ther (Inst),Daiichi Sankyo (Inst), Boehringer Ingelheim (Inst), Rain Therapeutics (Inst), Foghorn Ther Inc (Inst), Hutchinson MediPharam Lt (Inst), InhibRx (Inst), Ayala Pharmaceuticals (Inst.), Eli Lilly (Inst.), Abbisko Therapeutics Co. Ltd. (Inst.), Immunome (Inst.), Syneos Health (Inst.) The Author Elena Palassini reports the following COI: Institutional: Advenchen; Blueprint; Boehringer Ingelheim; Deciphera; EISAI; Eli Lilly; Epizyme Inc.; Daiichi Sankyo; Foghorn; Glaxo Smith Kline; HUTCHMED; Inhibrix; Karyopharm; Novartis; PharmaMar; Rain Therapeutic; SpringWorks; Cogent Biosciences; Ayala Pharmaceuticals; Abbisko Therapeutics Co. Ltd.; Immunome; IDRX, Inc.; Syneos Health The Author Salvatore Tafuto reports the following COI: Consultation for Novartis, Esteve, Camurus, Deciphera, Boehringer, Gentili, Ipsen. The Author Silvia Stacchiotti reports the following COI: honoraria, consultancy or advisory role: Bayer, Boehringer, Daiichi Sankyo, Deciphera, Gentili, Glaxo Smith Kline, Ikena, Ipsen, NEC Oncoimmunity, Novartis, Pharmamar, Pharma Essentia, Rain Therapeutics, Regeneron, Servier. Institutional financial interests: Abbisko, Advenchen, Bayer, Boehringer, Daiichi Sankyo, Deciphera, Eisai, Epizyme, Foghorn, Glaxo Smith Kline, Hutchinson, Inhibrix, Ipsen, Karyopharm, Novartis, Pharmamar, RainThera, Springworks

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