STREAM, among the first real-world programs of its kind, demonstrates WGS at scale with 300+ patients, clinically actionable insights in more than half of cases, and direct integration into tumor boards.

Inocras, a bioinformatics-led company harnessing the power of whole genome data and proprietary analytics to deliver curated insights that advance precision health, in collaboration with the Lee Kun-hee Child Cancer and Rare Disease Project, today announced results from the STREAM Program (Strategic TREatment And Magic for pediatric cancers). The project, established through a donation from the family of the late Samsung Chairman Lee Kun-hee, is the first nationwide, real-world precision oncology program for pediatric solid tumors in Asia, powered by Inocras’ clinical-grade whole genome sequencing (WGS) and bioinformatics platform. Findings will be presented at the American Association for Cancer Research (AACR) Special Conference on Advances in Pediatric Cancer Research, taking place September 25–28 in Boston.

Launched in Korea in 2023, STREAM integrates WGS, transcriptome and methylome profiling, and ex-vivo drug screening into routine pediatric care. The program has already profiled 308 children with malignant solid tumors and is on track to reach 500 patients in the near term, as part of a broader 10-year initiative targeting 2,000 patients nationwide.

Key Findings

• A total of 1,082 somatic driver mutations were identified across 308 patients, of which 56% (238 CNVs and 323 SVs) were non-SNV events.
• 82% of patients had at least one somatic driver, spanning more than 1,000 genomic events across 400+ genes.
• 10% carried pathogenic germline variants, supporting family counseling and early interventions.
• 59% of patients achieved clinically actionable results, leading to diagnostic refinement, therapeutic guidance, or clinical trial eligibility.
• Compared to adult cancers, pediatric tumors exhibited a 14-fold lower mutational burden and typically only two driver events per patient, highlighting pediatric-specific therapeutic vulnerabilities.
• Molecular profiling mirrored histology but also revealed new genomic clusters that more accurately predicted treatment response.
• Ex-vivo drug testing showed strong concordance with genomic signatures, enabling genome-guided therapy recommendations in real-world tumor boards. These findings support the design of future pediatric basket trials based on pathway dependencies rather than tumor morphology.

“This national-scale program shows that genome-guided care for children with cancer is no longer a future concept - it is happening right now in clinics,” said Jehee Suh, CEO of Inocras. “STREAM has already delivered clinically actionable findings in more than half of patients, driven in large part by structural and fusion variants, and is uncovering unique aspects of pediatric tumor biology such as low mutational burden and single pathway dependencies. With the support of the Lee Kun-hee Child Cancer and Rare Disease Project, we are demonstrating that Inocras’ whole genome sequencing works at scale in real-world pediatric oncology, delivering actionable insights that can directly impact young patients and their families.”

“This initiative represents a major step forward for pediatric cancer care in Korea and around the world,” said Dr. Ji Hoon Phi, Associate Professor, Division of Pediatric Neurosurgery of Seoul National University Children’s Hospital (SNUCH) and head of the solid tumor division under the Child Cancer and Rare Disease Support Project. “By embedding multi-omic profiling and ex-vivo drug screening into pediatric oncology workflows, and by revealing novel molecular subgroups that transcend traditional histology, we are setting a new standard for how children with cancer are diagnosed and treated. These findings are already informing treatment decisions today and will also help design the next generation of pediatric basket trials – advancing science and improving lives.”

Poster Presentation at AACR Pediatrics

Title: Nationwide Real-World Genome-Guided Care in Pediatric Solid Tumors: Results from the STREAM Program

Authors: Ji Won Lee, Chang Yeon Kim, Joo Whan Kim, June-Young Koh, Jung Yoon Choi, Seung-Ah Choi, Seung-Ki Kim, Se Hoon Kim, Ji Hoon Phi, and the STREAM Consortium

Session: Abstract AOO5, Poster Session A, Thursday, September 25, 7:00- 9:30 P.M. EDT, AACR Special Conference: Advances in Pediatric Cancer Research

About Inocras

Inocras is a bioinformatics-led company redefining precision health through whole genome data and proprietary analytics. Our oncology and rare disease platforms integrate comprehensive whole genome data with advanced automation to deliver curated and actionable insights at scale. These capabilities deliver curated, actionable insights that accelerate discovery and diagnostics to improve patient care, bringing a real-world impact. Inocras operates a CLIA/CAP-certified laboratory and partners with leading hospitals, pharmaceutical companies, and research institutions worldwide. For more information, please visit inocras.com and follow the Inocras LinkedIn page.

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This national-scale program shows that genome-guided care for children with cancer is no longer a future concept - it is happening right now in clinics.