ESMO – European Society for Medical Oncology shared on LinkedIn:
“Precision Oncology is generating an increasing volume and diversity of biomarker information, making treatment decisions more complex than ever.
The updated ESMO Scale for Clinical Actionability of molecular Targets (ESCAT v2) helps oncologists assess the clinical relevance of genomic alterations, interpret actionability biomarkers and classify resistance biomarkers through a transparent, evidence-based framework.
By helping translate complex molecular data into informed treatment decisions, ESCAT v2 supports the implementation of precision oncology in clinical practice.”
Title: The ESMO Scale for Clinical Actionability of Molecular Targets, version 2 (ESCAT v2): an evidence-based framework for ranking alterations as actionability and resistance biomarkers in precision oncology
Authors: A. El Helali, C. Cardone, N. Coleman, J.R. Beal, M.V. Cruz-Ordinario, E. Kocakavuk, M. K-l. Chiu, D. Thomas, C. Turnbull, F. Meric-Bernstam, M.F. Mosele, D. Chakravarty, R. Dienstmann, D. Tamborero, H.E.G. Russnes, M. Kordes, H.H.F. Loong, A. Stenzinger, J. Rueter, D. Martins-Branco, G. Pentheroudakis, J. Mateo, C.B. Westphalen
What is ESCAT v2?
A standardised ranking of tumour alterations․
The ESMO Scale for Clinical Actionability of molecular Targets (ESCAT) ranks genomic alterations by the strength of clinical evidence to guide targeted treatment․
How is ESCAT applied in practice?
Step 1: Broad gene panel or whole-exome sequencing generates a report that shows many mutated genes are in a patient’s tumour․
Step 2: ESCAT helps clinicians assign alterations a tier reflecting the evidence for matching that alteration to a drug in that tumour type․
Step 3: Tiering system helps clinicians choose the best personalised treatment․
ESCAT v2 has four new features:
- Tier I has been divided into three subtiers which help oncologists understand how certain the evidence is
- Lower tiers have been refined:
Tier II has three subtiers with explicit data-quality rules
Tier X is split into X-A (tested, not predictive) and X-B (drug inactive)
- Tumour-agnostic screen (ETAC-S). A defined set of criteria that decides when evidence applies across tumour types
- A resistance scale. A parallel four-level scale grades biomarkers that predict reduced or absent benefit
ESCAT acts as a common language for:
Oncologists: Guides the prioritisation of potential drug targets when receiving multigene panel reports․
Molecular pathologists: Assists the reporting of tiers alongside genomic findings․
Multidisciplinary Tumour Boards: Gives a shared framework for discussing results․
Drug Developers: Places targets in their clinical context and reveals evidence to upgrade them․
“ESCAT will bring order to the current jungle of mutation analysis so that we all speak the same language for classifying mutations and prioritising how we use them to enhance patient care.”
Other articles about ESCAT and precision oncology on OncoDaily.