2026/04/09 by Marcus Renner, Małgorzata Oleś, Nagarajan Paramasivam +43 · 1 voice
Medicine · Biochemistry, Genetics and Molecular Biology · #Sarcoma Diagnosis and Treatment #Protein Degradation and Inhibitors #Chromatin Remodeling and Cancer
paper · pdf · doi:10.1038/s41467-026-71636-0
openalex publication_date 2026/04/09 · openalex created_date 2026/04/10 · openalex updated_date 2026/07/29
Desmoplastic small round cell tumor (DSRCT) is an ultra-rare sarcoma with limited treatment options. Here, we show that comprehensive molecular profiling informs diagnosis and individualized therapy in this disease. We report the results of whole-genome/exome, transcriptome, and DNA methylome analyses performed in 30 refractory DSRCT patients, complemented by (phospho)proteomic profiling in nine, within a nationwide precision oncology program. In eight patients (27%), DSRCT was diagnosed only after molecular profiling. Although DSRCTs have "quiet" genomes, 28 patients (93%) received 107 molecular-based management recommendations, including assessment of clinical trial eligibility in 17 (57%). Most recommendations are informed by overexpression of tyrosine kinases, SSTR3/5, and CLDN6, detected in 45%, 33%, and 20% of cases, respectively. Thirteen patients (46%) received recommended therapies, yielding disease control in eight (62%), including three long-lasting responses to pazopanib and trastuzumab deruxtecan, the latter administered based on ERBB2 overexpression in the absence of aberrant ERBB2 kinase activation. These findings demonstrate that multi-omics profiling provides clinically actionable insights for DSRCT management.