Finding a Cancer Treatment (NCI-)MATCH

In 2015, the ECOG-ACRIN Cancer Research Group (ECOG-ACRIN) and the National Cancer Institute (NCI) teamed up to run the largest precision medicine cancer trial to date – the NCI-Molecular Analysis for Therapy Choice (NCI-MATCH). The aim? To test the genetic profile of tumors and match patients to targeted treatments without limiting the trial to one type of cancer or to approved drugs (1).

Before the trial, the frequency of tumor gene abnormalities across cancer types was unknown. But the study found a 37.6 percent chance of a tumor’s having a defect that matches a targeted drug – a rate that the researchers hope will demonstrate to clinicians the value of genetic testing. Match rate varied across cancer types, with rarer cancers matching at higher rates than more common types – highlighting the lack of targeted treatments for mutations within those cancers. It was also common for several tumor gene abnormalities to drive cancer growth simultaneously, suggesting that combination therapies may be effective for many patients.

But how might this translate to the clinic? Findings from the Mayo Clinic INTERCEPT study show that the standard guidelines clinicians use to identify patients for genetic testing only catch 48 percent of eligible patients with an inherited genetic mutation (2). NCI-MATCH may help to solve this problem, with the published datasets informing clinicians on how to best use genomic testing to guide treatment decisions. But it doesn’t end there – ECOG-ACRIN and the NCI are also engaging with the pharmaceutical industry to open multiple treatment arms in the trial, providing valuable insights into responsive and unresponsive cancers.

“NCI-MATCH is a unique and groundbreaking trial that will continue to make major contributions in years to come as genomic findings from individual treatment arms, correlated with outcomes, are released,” said Lyndsay Harris, MD, Translational Co-chair of NCI-MATCH (3).