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Article History

Received: 20 June 2025

Revised: 5 September 2025

Accepted: 6 September 2025

First Online: 12 September 2025

Declarations

:

: R.J. Young reports equity in Agios, and consulting fees from Guerbet, ICON plc, NordicNeuroLab, Olea Medical, RadMD, Servier, and Turing Medical, unrelated to the present work. N.S. Moss has consulted/received speaking fees from AstraZeneca, Daiichi Sankyo and Varian, and received research funding (to institution) from AZ, Amgen and GT. A. Boire is an inventor on the following patents: 62/258,044, 10/413,522, and 63/052,139. C. Grommes reports honoraria from Scripps Health; consulting or advisory roles from BTG, Kite/Gilead, Ono Pharmaceutical, Roche, Curis; speakers’ bureau from Ono Pharmaceutical; travel, accommodations, and expenses from Ono Pharmaceutical, Bayer, Bristol Myers Squibb, Pharmacyclics, Celgene, unrelated to the present work. B.D. Santomasso has received consulting honoraria from Bristol-Myers Squibb, Johnson & Johnson, Janssen, and Gilead and serves on the scientific advisory board of In8bio, all unrelated to the present work. E.L. Diamond discloses unpaid editorial support from Pfizer Inc, unrelated to the present work. T.J. Kaley reports other support from Servier, unrelated to the present work. I.K. Mellinghoff reports researcher fees from Servier, Erasca, Abbvie, Roche, and Global Coalition for Adaptive Research, speaker fees from Baptist Health Care, grants from Indiana University School of Medicine, and advisory board fees from Tango Therapeutics and Pathos Inc, all unrelated to the present work. M. Berger reports personal fees from AstraZeneca and Paige.AI, research support from Boundless Bio, and intellectual property rights from SOPHiA Genetics. Z.K. Stadler has intellectual property rights in SOPHiA Genetics and serves as an Associate Editor for JCO Precision Oncology and as a Section Editor for UpToDate. Z.K. Stadler's immediate family member serves on the Board of Directors for Adverum Biotechnologies, is Co-Founder, CMO and President for Blue Gen Therapeutics Foundation, and serves as a consultant in Ophthalmology for Apellis, Gyroscope, Nanoscope, Novartis, Outlook Therapeutics, and Regeneron unrelated to the present work. A.L. Lin reports funding from Bristol Myers Squibb, unrelated to the present work. All remaining authors have declared no conflicts of interest.

: Patients in this study were enrolled on a sequencing protocol (NCT01775072) that was approved by the Institutional Review Board of Memorial Sloan Kettering Cancer Center and conducted in accordance with International Ethical Guidelines for Biomedical Research Involving Human Subjects, Good Clinical Practice guidelines, the Declaration of Helsinki, as well as federal laws, after providing written informed consent.