ATYPICAL RESPONDERS LANDSCAPE REVIEW ∙ OCTOBER, 2017 4 Understanding the reasons underlying atypical responses and exceptional survival is critical to advancing the success of personalized medicine. Therefore, the Metastatic Breast Cancer Alliance calls for: 1. Unified categories of, and criteria for, exceptional responders, rapid progressors, and exceptional survivors 2. Enhancing clinical trial design to study exceptional responders and rapid progressors relative to treatment outcomes. Exceptional survivors who enroll in clinical trials can be readily identified by the date of their MBC diagnosis, and specific methodologies to study these patients are needed. 3. Funding studies that expand upon the role of genetics in atypical responses by integrating other factors including CIM, co-morbidities, and the entire patient, without limiting the study to genetics 4. Sharing standardized, de-identified patient information that is generated from these studies in a secure centralized data repository that is accessible to authorized scientists and researchers Detailed studies of both normal and atypical responses to treatment will be needed to enhance the understanding of the role of non-tumor factors. Clinical trial design for targeted and other types of therapies should be enhanced to collect data in a standardized manner beyond tumor genetics, resulting in a more thorough study of the whole patient.