2/X #ESMO23 - The CUPISCO idea: Integration of vigorous clinical and pathological workup, comprehensive molecular profiling and a study wide molecular tumour board will allow patients to benefit from targeted treatments after induction chemotherapy.

3/x #ESMO23 CUPISCO numbers: 🔎1505 #patients screened ✅636 #patients enrolled 🎲436 #patients randomised 3:1 🎯326 #patients received therapy based on the MTB recommendation Primary endpoint:Progression free survival📉

4/X #ESMO23 Baseline characteristics were balanced between the two groups & the response to induction chemotherapy was not different.

5/X #ESMO23 CUPISCO is the first randomised positive #PrecisionMedicine trial. In the ITT, #patients receiving a therapy based on genomic profiling & the MTB had a longer PFS than patients in the chemotherapy arm.

6/X #ESMO23 Importantly, even after splitting into subgroups (PFS in months) -Chemotherapy: 4.4 -Chemotherapy + #Immunotherapy : 5.5 -Targeted therapy: 8.1 #patients benefited molecularly guided treatment

7/X #ESMO23 Why is this important? 1/2 CUPISCO tested the complete management of #patients w CUP & the effect of targeted treatment based in a #patient population with dismal prognosis. This trial concept shows that #PrecisionMedicine can be tested in a randomised fashion.

8/X #ESMO23 Why is this important? 2/2 This trial can serve as a starting point for discussions around trials allowing access to both innovative diagnostics & targeted treatments even in complex & heterogeneous populations.

@BenWestphalen @myESMO @OncoAlert Thanks @BenWestphalen for the fantastic summary

@LindaMileshkin @myESMO @OncoAlert My pleasure - congratulations to you and the team for pulling this off. Still a long way to go…but with CUPISCO we made the first steps into the right direction.

@BenWestphalen @LindaMileshkin @myESMO @OncoAlert Congrats @LindaMileshkin and CUPISCO team, important trial in a challenging disease #precisiononcology #mtbforall #ESMO23

@BenWestphalen @LindaMileshkin @myESMO @OncoAlert Congratulations Linda.