SPROUT Guidelines for Molecular Profiling for Children with Solid Tumors: A Consensus Recommendation from the American Association for Cancer Research

Purpose: Molecular diagnostics are standard of care for most adults with solid malignancies, but implementation in pediatric solid tumors remains inconsistent. The SPROUT (Somatic Profiling for Pediatric Cancer Refining our Understanding and Treatment) Molecular Guidelines Working Group was convened to develop molecular testing guidelines for pediatric solid tumors. Experimental Design: A structured literature review was performed using Covidence to identify relevant clinical studies evaluating molecular diagnostics in pediatric solid tumors. The literature and collective clinical experience of the multidisciplinary working group were used to develop consensus recommendations for molecular profiling at diagnosis and at relapse or recurrence. Results: Of 361 manuscripts screened, 41 studies were included for data extraction. Based on the available evidence and expert consensus, recommendations were developed for the use and timing of DNA and RNA next-generation sequencing and methylation profiling across pediatric solid tumors. Conclusions: The SPROUT Molecular Guidelines provide a framework for standardized implementation of molecular diagnostics in pediatric solid tumors. Broad adoption of these recommendations may improve diagnostic precision, reduce variability in molecular testing, and increase opportunities for biomarker-directed therapy and clinical trial enrollment for children with cancer.