NCI-MATCH trial reveals actionable mutations and matches cancer patients to targeted therapies
The NCI-MATCH trial was designed to reveal mutations in underexplored cancer types, allowing researchers to match patients to appropriate targeted therapies.
- NCI-MATCH has more than 1,000 participating sites.
- The trial is open to patients with advanced cancers that have progressed on standard treatment or rare cancers for which there is no standard treatment.
- Investigators use next-generation sequencing to identify mutations in tumor biopsies taken before the start of therapy.
- Sequencing is performed at MD Anderson Cancer Center, Houston; Massachusetts General Hospital, Boston; MoCha at NCI’s Frederick (Md.) National Lab; Yale University, New Haven, Conn.; and commercial labs.
Matching patients to treatment
- When a patient is found to have an actionable mutation, that patient is assigned to an investigational treatment, typically monotherapy.
- A patient cannot be assigned to a treatment that is already known to be effective against their cancer; for example, patients with BRAF-mutated melanoma were excluded.
- The NCI’s Cancer Therapy Evaluation Program sends the patient's targeted therapy to the participating site within 24 hours of notification.
- CT imaging is done prior to the start of treatment, and patients are monitored with repeat scans every two cycles.
- Data on 5,954 patients with refractory malignancies were recently reported (J Clin Oncol. 2020 Nov 20;38:3883-94).
- About 38% of those patients had an actionable mutation, and about 18% were assigned to a targeted therapy.
- Reports have shown varying response rates to matched therapy, ranging from 2% to 38%, Dr. Chen said.
- Results from the trial's treatment arms can be found here: https://ecog-acrin.org/nci-match-eay131-findings.
- Dr. Chen noted that this trial was designed to match patients with single agents.
- Combination therapy has only been used in one arm of the study (J Clin Oncol. 2020 Aug 06. doi: 10.1200/JCO.20.00762).
- Nine treatment arms are still open, and one arm has yet to open.
- Conclusions are still pending the completion of the treatment arms.
- The next step for this research is expanding to include more combination therapies.
- There is also interest in comparing biopsies of tissue obtained at initial diagnosis and after treatment to further improve understanding of mutations.
- For more information on NCI-MATCH, visit:
Show notes written by Sheila DeYoung, DO, a resident at Pennsylvania Hospital, Philadelphia.
Dr. Chen and Dr. Henry have no conflicts of interest.
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