The NCI-MATCH trial: lessons for precision oncology

Area of Science:

• Oncology
• Genomics
• Clinical Trials

Background:

• The NCI-MATCH (Molecular Analysis for Therapy Choice) trial was a large-scale, genomically driven precision medicine platform trial initiated in 2015.
• It focused on patients with treatment-refractory, malignant solid tumors, aiming to match therapies to specific genomic alterations.

Purpose of the Study:

• To evaluate the efficacy of targeted therapies in patients with specific genomic alterations in refractory solid tumors.
• To assess the signal-seeking objective of matching therapies to molecular targets in a broad patient population.

Main Methods:

• Nearly 6,000 patients underwent screening and molecular testing.
• 1,593 patients were assigned to 38 phase 2 substudies, each testing a therapy matched to a genomic alteration.
• Objective tumor response by RECIST criteria was the primary endpoint for each substudy.

Main Results:

• The NCI-MATCH trial met its signal-seeking objective, with 7 out of 27 (25.9%) initial substudies showing positive results.
• These findings indicate successful identification of therapies effective against specific genomic alterations.

Conclusions:

• The NCI-MATCH trial demonstrated the feasibility and value of a tumor-agnostic, precision oncology approach.
• Key lessons learned from its design and operational conduct will inform future precision medicine studies.