Implementing Precision Medicine in cOmmunity HospiTALs

Patients will be selected to present a metastatic cancer (de novo or relapse after primary tumor treatment) eligible for a first line treatment (chemotherapy, immunotherapy, endocrine therapy or targeted therapy).

All tumor subtype could be enrolled in the study; metastatic prostate cancer must be resistant to castration. Triple negative breast cancer and Hormone receptor positive, Her2-negative metastatic breast cancer resistant to endocrine therapy are eligible to the study.

A plasma sample will be collected at baseline and will be tested for a large panel of gene and MSI status using Next Generation Sequencing (NGS) (cf table). Results will be discussed within a Molecular Tumor Board (MTB) with all declared centers.

Inclusion criteria

Participants are eligible to be included in the study only if they meet all of the following criteria:

• Age ≥ 18 years
• Histology: solid malignant tumor
• Locally advanced/unresectable and/or metastatic (for prostate cancer: castration resistant prostate cancer, for RH+/HER2- breast cancer: prior treatment with endocrine therapy plus anti-CDK4/6 inhibitor)
• Eastern Cooperative Oncology Group (ECOG) performance status < 2
• Measurable disease as per RECIST criteria
• Patient with a social security in compliance with the French law relating to biomedical research (Article L.1121-11 of French Public Health Code)
• Voluntary signed and dated written informed consent prior to any study specific procedure.

Exclusion criteria

Participants will be excluded from the study if they meet any of the following criteria:

• Radiological evidence of symptomatic or progressive brain metastases
• Previous or current malignancies of others histologies within the last 2 years, with the exception of in situ carcinoma of the cervix, and adequately treated basal cell or squamous cell carcinoma of the skin and prostate cancer
• Any condition which in the Investigator's opinion makes it undesirable for the subject to participate in a clinical trial or which would jeopardize compliance with the protocol
• Patient under guardianship or deprived of his liberty by a judicial or administrative decision or incapable of giving its consent
• Minors (Age < 18 years)
• Pregnant or breast-feeding women
• Previous enrollment in the present study.