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Clinical utility of whole transcriptome sequencing for fusion detection in advanced solid tumors: SCRUMJapan MONSTAR-SCREEN-2

Key Findings

  • Whole transcriptome sequencing (WTS) identified pathogenic fusion variants in 5.4% of advanced solid tumors in the SCRUM-Japan MONSTAR-SCREEN-2 study, including clinically actionable kinase fusions.
  • More than half of pathogenic fusions identified by WTS would theoretically have been missed by conventional targeted DNA panel sequencing, including FGFR2, FGFR3, and BRAF rearrangements.
  • WTS identified clinically relevant fusions that informed targeted therapy selection, including a BRAF fusion in melanoma undetected by conventional DNA panel testing.
  • These findings demonstrate how WTS can expand detection of actionable genomic alterations beyond conventional DNA-based approaches, supporting broader implementation of RNA profiling in precision oncology
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