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ASCO 2026 | WTS for fusion detection in solid tumors: SCRUM-Japan MONSTAR-SCREEN-2

Takao Fujisawa, MD, PhD, National Cancer Center Hospital East, Kashiwa, Japan, presents findings from SCRUM-Japan MONSTAR-SCREEN-2 (UMIN000043899), a nationwide molecular profiling project evaluating whole transcriptome sequencing (WTS) for fusion variant detection in advanced solid tumors. The study demonstrated that WTS identifies pathogenic gene fusions and structural variants frequently missed by conventional targeted DNA panel sequencing, including druggable kinase fusions. Patients receiving kinase fusion-targeted therapy showed meaningful clinical responses, underscoring the potential utility of WTS in guiding precision oncology treatment decisions. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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Transcript

At first, let me introduce our platform, MONSTAR-SCREEN-2. MONSTAR-SCREEN-2 is a precision oncology platform in Japan, which targets more than 2,000 patients with advanced solid tumors. In MOSA Screen, as you know, the RNA fusion variant is a very important target in solid tumors. But unfortunately, the conventional DNA target panel sequencing often misses the important DNA fusion variant detection...

At first, let me introduce our platform, MONSTAR-SCREEN-2. MONSTAR-SCREEN-2 is a precision oncology platform in Japan, which targets more than 2,000 patients with advanced solid tumors. In MOSA Screen, as you know, the RNA fusion variant is a very important target in solid tumors. But unfortunately, the conventional DNA target panel sequencing often misses the important DNA fusion variant detection. And the RNA sequencing may detect more sensitively than the DNA panel sequence. And in MONSTAR-SCREEN-2, we perform the whole transcriptome sequencing in parallel to the whole exome sequencing. So in this analysis, we perform the clinical utility of the RNA sequencing for detection of the RNA fusions. In analysis, the approximately 5% of the patients harbor the fusion-by-fusion variants. And interestingly, the 60% of the fusion variants can’t be detected with DNA panel sequencing, can’t be detected with it by RNA sequencing.

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