The iCat2, GAIN (Genomic Assessment Informs Novel Therapy) Consortium Study

Inclusion Criteria: * Age -- Age ≤ 30 years at time of initial qualifying solid tumor diagnosis * Diagnosis -- Histologic diagnosis of solid malignancy (excluding brain tumors and lymphoma) that meets at least one of the following criteria: * Refractory, defined as tumor progression after initiation of standard first line therapy without having achieved a prior partial or complete remission OR Biopsy proven residual disease at the completion of planned standard initial front-line therapy. * Recurrent, defined as tumor progression after achieving a prior partial or complete remission * Newly diagnosed high risk disease, defined as having an expected event free survival of \< 50% at 2 years. * Lacks definitive diagnosis or classical genomic findings after histologic review and standard molecular testing (rare tumor group). * Examples include (eligibility not limited to these examples): * Histology typically associated with a fusion in which fusion is not detected. * Ewing-like sarcoma * Undifferentiated sarcoma * Inflammatory myofibroblastic tumor without ALK fusion * Infantile fibrosarcoma without NTRK fusion * Specimen Samples * Sufficient tumor specimen available to meet the minimum requirements for profiling from diagnosis or progression / recurrence \--- OR * Surgery / biopsy planned as part of clinical care that is anticipated to yield sufficient material to meet the minimum requirements for profiling; OR * Patient has already had molecular profiling and patient has not yet started matched targeted therapy based on the report . Exclusion Criteria: * No Therapy Planned \-- Patients who have declined further anticancer therapy will be excluded. * Performance Status \-- Patients with Lansky (age \< 16 years) or Karnofsky (age ≥16 years) score \< 50 will be excluded. * Life Expectancy -- Patients with anticipated life expectancy \< 3 months will be excluded.