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