SCRUM‐Japan GI‐SCREEN and MONSTAR‐SCREEN: Path to the realization of biomarker‐guided precision oncology in advanced solid tumors

Comprehensive genomic profiling enables the detection of genomic biomarkers in advanced solid tumors. However, efficient patient screening for the success of precision oncology remains challenging due to substantial barriers, such as genotyping costs and accessibility to matched therapies. To address these challenges, we launched GI‐SCREEN, a nationwide gastrointestinal cancer genomic screening project within the SCRUM‐Japan network in 2015 with the specific purpose of matching patients with a diverse portfolio of affiliated interventional targeted therapy trials. Subsequently, we initiated the molecular profiling projects GOZILA, MONSTAR‐SCREEN‐1, and MONSTAR‐SCREEN‐2, which incorporate tissue and plasma multiomics approaches to accurately identify patients with advanced solid tumors who would benefit from matched therapies. These projects have led to a significant increase in patient participation in targeted clinical trials and the approval of several therapeutics and companion diagnostics. Additionally, clinicogenomic analyses utilizing the SCRUM‐Japan database have provided new insights into the molecular mechanisms of advanced solid tumors. In this review, we describe the path to the realization of cancer precision medicine for patients with advanced solid tumors based on the SCRUM‐Japan GI‐SCREEN and MONSTAR‐SCREEN platforms. Recent advances in precision oncology have highlighted the necessity of performing genotyping for patients with advanced cancer to select appropriate therapies. However, the pace of innovation in precision oncology is limited by the logistical hindrance of patient identification and the need for large‐scale cancer genomic screening platforms. In the submitted article, we reviewed the development of the SCRUM‐Japan GI‐SCREEN and MONSTAR‐SCREEN Project, a nationwide cancer genomic screening project in Japan, conducted to facilitate precision oncology.