D14.2 Can.Heal final set of recommendations for the adoption of personalised approaches into EU health system

The deliverable provides the final set of recommendations for the adoption of personalised approaches into EU health system, which will be developed following a co-creation approach ensured by a strong stakeholder engagement done in collaboration with WP2. The recommendations will be developed after a Delphiconsultation with Key Stakeholders (in collaboration with WP2) and public discussion with the main institutional health bodies (Health Ministries, National Health Institutes, Cancer Center). Recommendations’ target audience are policy and decision makers, healthcare professionsals. Deliverable 14.2 presents a consolidated set of evidence-informed recommendations focused on the integration of three innovative approaches in cancer prevention, diagnosis, and care: Polygenic Risk Scores (PRS) in Breast Cancer Screening, Liquid Biopsy (LB) in the management of metastatic Colorectal Cancer (mCRC), and Molecular Tumor Boards (MTBs) in oncology care pathways. These recommendations were developed through structured expert consultation and synthesis of the latest available evidence, while acknowledging the evolving nature of clinical and implementation research in these domains. 1. Polygenic Risk Scores (PRS) in Breast Cancer Screening This section conditionally recommends the exploration of PRS integration into national or sub-national breast cancer screening programs in the EU. Given the low certainty of evidence and context-dependent outcomes, the use of PRS should remain within prospective research, pilot programs, or controlled implementation studies. A Phase III randomized controlled trial (RCT) may be justified in the future if ongoing research leaves critical uncertainties unresolved. Tailored guidance is provided for policymakers, researchers, clinicians, and the public—emphasizing equity, feasibility, and communication. 2. Liquid Biopsy in the Management of Metastatic Colorectal Cancer (mCRC) This section offers a conditional recommendation to explore the use of ctDNA-based liquid biopsy in mCRC management, distinguishing between its roles in tumor genotyping and monitoring therapeutic response. While liquid biopsy shows analytical validity and early clinical promise, its routine use is not yet supported. The recommendations call for structured implementation studies and highlight the need for further validation of clinical utility. Guidance is provided for health authorities, researchers, clinicians, and patients, with emphasis on the need for transparent communication and multidisciplinary interpretation. 3. Molecular Tumor Boards (MTBs): A Policy Brief for Personalized Cancer Care This section recommends the structured integration of MTBs into EU oncology care pathways, emphasizing that MTBs are essential to enabling precision oncology. Rather than prescribing a single model, the brief outlines core principles adaptable to local contexts. It encourages investments in infrastructure, workforce training, clinical sequencing, and data sharing frameworks. Stakeholder-specific recommendations include actions for policy leaders, researchers, clinicians, and the public, aiming to ensure equitable, scalable, and sustainable implementation of MTBs across health systems.