10011 Background: The role of molecular profiling in the clinical care of children with advanced solid tumors is unknown. Key questions are: do pediatric solid tumors have a sufficient rate of actionable alterations to warrant prospective assessment for clinical use; and, if potentially actionable alterations are identified are targeted drugs accessible for use in children with recurrent solid tumors? Methods: We conducted a multi-institution study to determine whether it is feasible to identify actionable alterations and make an individualized cancer therapy (iCat) recommendation using currently available clinical genomic technologies. Patients(pts) were eligible if they had a diagnosis of a high risk or recurrent/refractory solid tumor. Tumor profiling consisted of: a)mutation detection by either a Sequenom assay or targeted next-generation sequencing; b)copy number assessment by array CGH; and c)validation with IHC/FISH in some cases. Tumor profiling results were reviewed by a multi-disciplinary expert...