Abstract
Precision medicine trials aim to provide evidence that targeting particular molecular abnormalities with specific treatment will result in better efficacy than current methods. While we know certain instances where the tumor type influences response to these agents, there are other instances where responses can be seen in various malignancies if they have the same molecular abnormality. Currently we do not know much about why some tumors or even most tumors will respond to a treatment, given the same mutation, and some do not. NCI MATCH is a national signal-finding trial for patients with solid tumors or lymphomas that have progressed after standard treatment. Patients register to a screening trial, have a biopsy of their tumor, and the tumor is analyzed by a targeted next generation sequencing panel and appropriate other molecular assays, and if an actionable mutation (one that can be addressed in MATCH) is found, the patient is evaluated for treatment with the appropriately matched drug(s). The goal is to seek a signal that targeting a molecular abnormality across tumors can be successful. The trial is open in hundreds of academic and community oncology sites through the National Clinical Trials Network of the NCI. The trial uses rules by which to assign a treatment, and depends on previous evidence that a given molecular abnormality is involved in cancer maintenance, and/or could result in a response to a given treatment. As most molecular abnormalities will occur in 10% or less of patients, the trial requires a large screening population and a large number of treatments within it. The trial is meant to change to accommodate new knowledge, and to expand as necessary to follow signals. We have an opportunity to study additional problems within NCI MATCH as well, such as molecular features of responders vs. non-responders, evaluation of genomic knowledge of patients, potential inheritable abnormalities that are also seen in the tumor, as well as study recruitment and retention issues within the trial. The talk will discuss the rules created for the trial, the initial early challenges, and some new areas of exploration going forward.
Citation Format: Barbara A. Conley. NCI MATCH: A national precision medicine trial – Conception, development, and adjustment. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr IA38.
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