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The NCI-MATCH trial: lessons for precision oncology

Peter J O'Dwyer1, Robert J Gray2, Keith T Flaherty3

  • 1University of Pennsylvania, Philadelphia, PA, USA. peter.odwyer@pennmedicine.upenn.edu.

Nature Medicine
|June 15, 2023
PubMed

Insights

The NCI-MATCH trial, a large precision medicine study for refractory cancers, identified targeted therapies for 25.9% of its substudies. This platform trial offers valuable insights for future genomic-driven cancer research.

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.

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