MASTER – Innovation Driver for Personalised Oncology

The MASTER (Molecularly Aided Stratification for Tumour Eradication Research) program is a personalised oncology network that illustrates the clinical potential of full genetic analyses and individually tailored therapy in young adults with advanced cancers and patients with rare tumours for which often only few treatment options are available.

MASTER was founded in 2012 at the German Cancer Research Center (DKFZ) and the National Center for Tumour Diseases (NCT) in Heidelberg. Today, it includes all sites of the German Cancer Consortium (DKTK) and several comprehensive cancer centers. In total, well over 100 partners representing the entire spectrum of cancer patient care – from university hospitals to oncologists in private practice – have contributed to the program’s success.

Molecular tumor board discussing personalised medicine approach
Molecular tumour board discussing personalised medicine approach. © NCT Heidelberg, Fotograf: Philip Benjamin

Since its inception, MASTER has been an innovation driver for personalised oncology. On the one hand, the program has implemented the clinical application of full genetic characterization, i.e., the analysis of more than 20,000 genes, from the very beginning. Also, key structural elements of personalised oncology in Germany have been piloted and developed, e.g., cross-site molecular tumour boards and common standards for evaluating and reporting genetic alterations in the clinical context. Most importantly, the program’s results to date suggest that such comprehensive diagnostics can improve the care of patients with advanced cancers for whom standard treatment is exhausted:

  • In about 80% of patients, evidence-based treatment recommendations can be made based on the genetic findings.
  • These recommendations can currently be implemented in one-third of cases, of which about 50% show a partial regression or stabilization of their disease.
  • In almost 5% of cases, the molecular data can contribute to a more precise clinical diagnosis.
  • In more than 10% of patients, a hereditary predisposition to develop cancer is found, which is essential for both the affected patients and their families.

A further achievement of the MASTER consortium is the development of a growing portfolio of molecularly informed clinical trials. In these trials, patients are stratified (e.g., selected or grouped) based on the molecular characteristics of their specific tumour. They are planned and conducted in close cooperation with pharmaceutical companies, which in turn have a strong interest in the most comprehensive characterization of study patients to precisely define indication areas and target populations.

“The DKFZ/NCT/DKTK MASTER program aims to promote both the care of patients with cancer and the continuous development of diagnostic and therapeutic standards, i.e., to provide an interface between research and clinical application. This – together with the testing of new therapeutic strategies in a controlled and quality-assured setting – will ensure that the excellent conditions for personalised oncology in Germany and beyond are optimally used to improve the care of all cancer patients in the long term.”

Prof. Stefan Fröhling, DKFZ and NCT Heidelberg, Heidelberg, Germany

The personalised cancer medicine of the future requires an integrative concept for molecular diagnostics that includes both focused and thus readily scalable investigations, e.g., panel sequencing, and comprehensive analyses such as genome and RNA analysis. Here, MASTER offers the opportunity to test innovative methods by connecting to state-of-the-art research infrastructures such as those at DKFZ/NCT. Thus, the MASTER network represents an innovation hub that promotes “breadth” and innovation in equal measure and seamlessly links new technologies with clinical oncology. The development of comprehensive, high-quality molecular diagnostics will make it possible to continuously advance genome-based, individually tailored cancer medicine to support future patient care.