As precision oncology increasingly emphasizes tailoring treatment to specific molecular mechanisms and the tumor immune microenvironment, genomic alterations such as del(17p)/TP53 disruption, NOTCH1 or BIRC3-altered trisomy 12, and highly complex multichromosomal SV/CN profiles provide a biologic framework for thinking about which patients may benefit from targeted strategies or novel agents outside of conventional chemoimmunotherapy [35]. This evidence concerns the gene NOTCH1 and neoplasm.