EXPRESS: EXcePtional RESponSe - Exceptional and Unexpected Response to Targeted Therapies

Inclusion Criteria:

1. Adult patient ( ≥18 years old at diagnosis).
2. Provision of signed and dated, written informed consent prior to any study specific procedures, sampling and analyses.
3. Patient suffering from the following tumor type: breast cancer, lung adenocarcinoma or squamous cell carcinoma, colorectal cancer, ovarian cancer, renal clear cell cancer, skin cutaneous melanoma.
4. Metastatic or locally advanced disease.
5. Currently or previously treated with an anticancer targeted therapy in monotherapy. Targeted therapies combined with other agents are accepted only if 1/ the tumor was previously proven to be progressive under the same agents or 2/ the response or the stability has been maintained with the targeted therapy alone after the agent has been stopped.
6. Exceptional and unexpected tumor response to any marketed targeted therapy confirmed by the college of experts and defined as: complete response or partial response lasting more than six months, and not expected in more than 10% of the patients in this drug organ situation.
7. Availability and required quality of the tumor biopsy (FFPE or frozen sample) allowing for the whole exome sequencing analysis. Tumor biopsies obtained just before the initiation of the targeted therapy are preferred; otherwise any prior sample is possible.
8. Availability of normal tissue along with the tumor tissue, otherwise blood sample in order to extract constitutional DNA.

Exclusion Criteria:

1. Pediatric patient (\<18 years old at diagnosis).
2. Hematological malignancy or solid tumors, which are not in the scope of tumor types described in the inclusion criteria.
3. Tumor sample not available or not reaching the required quality for whole exome sequencing analysis.
4. Absence of confirmation of the exceptional and unexpected pattern of response by the college of experts as defined above.