Influencing Next-Generation Oncologic Outcomes Through Rapid Integration of Functional Precision Medicine (NOORI): A Feasibility Study of SmartMatch in Rare Gynecologic Cancers

Inclusion Criteria:

* Age ≥ 18 years
* Histologically confirmed rare gynecologic malignancy, including but not limited to those listed
* Metastatic or unresectable disease, OR disease for which additional systemic therapy is indicated
* Fresh tumor tissue available from a SOC surgical procedure or biopsy that in the judgment of the treating team will yield adequate viable tumor for SmartMatch analysis
* Eastern Cooperative Oncology Group (ECOG) performance status 0-2
* Adequate organ function to receive systemic therapy as determined by the treating oncologist (protocol does not specify thresholds because therapy is not mandated)
* Ability to understand and willingness to sign informed consent
* Willingness to allow data abstraction from the electronic health record for study endpoints

Exclusion Criteria:

* Lack of tumor tissue suitable for SmartMatch analysis
* Purely borderline tumors or benign ovarian/uterine neoplasms
* Any condition that, in the opinion of the treating oncologist or PI, would interfere with receiving systemic therapy
* Inability to provide informed consent or comply with study procedures