Celebrating the 10th Anniversary
A decade of discoveries in Cancer Discovery. For the community. By the Community.
Opening Shots in the BATTLE of Precision Medicine
The very first issue of Cancer Discovery featured the Biomarker-integrated Approaches of Targeted Therapy for Lung Cancer Elimination (BATTLE) trial by Kim, Herbst, Wistuba, Lee, Lippman, the late Waun Ki Hong, and colleagues, the first completed prospective, biomarker-based, adaptively randomized clinical trial in patients with lung cancer. Unlike most clinical trials at the time, the BATTLE trial required core tumor biopsies upon enrollment so that up-to-date biomarker status could be assessed. Patients were then randomized into one of four treatment arms (erlotinib, vandetanib, erlotinib plus bexarotene, or sorafenib), and the 8-week disease control rate was determined and compared with historical controls. The adaptive Bayesian design, which was not common at the time, attempted to increase the opportunity for each patient to receive the most effective treatment. The BATTLE trial represented a major advance in clinical trial design that established the feasibility of performing core biopsies and real-time biomarker analysis to assign therapy. It paved the way for future trials as our understanding of lung cancer biology advanced and more specific drugs were developed.