Fig. 4. Comparison of therapy- and biomarker-focused-tiering approach.

A schematic diagram comparing the two different tiering approaches. a In a biomarker-focused approach (e.g., AMP/ASCO/CAP system), a tier is assigned to a molecular alteration to indicate its clinical significance; complete list of therapies is not explicitly assessed. b In contrast, TOPOGRAPH—which uses a therapy-focused approach to review literature—assigns a tier to each therapy (instead of a biomarker) to indicate the strength-of-recommendation based on available evidence. This approach identifies and ranks potentially actionable treatment options with respect to the clinicopathologic contexts (e.g., cancer type). AMP Association for Molecular Pathology, ASCO American Society for Clinical Oncology, CAP College of American Pathologists, FDA U.S. Food and Drug Administration, FU Fluorouracil, GOJ Gastro-oesophageal junction, NSCLC Non-small-cell lung cancer.