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The evolution of precision oncology: The ongoing impact of the Drug Rediscovery Protocol (DRUP)

Soemeya F Haj Mohammad1, Hans J L Timmer2, Laurien J Zeverijn3

  • 1Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands; Department of Molecular Oncology & Immunology, Netherlands Cancer Institute, Amsterdam, the Netherlands. s.f.haj_mohammad@lumc.nl.

Acta Oncologica (Stockholm, Sweden)
|May 23, 2024
PubMed
Abstract

Insights

The Drug Rediscovery Protocol (DRUP) trial offers off-label targeted and immunotherapies to advanced cancer patients. While overall benefit is 33%, specific treatments show varied success, highlighting precision oncology

Area of Science:

  • Oncology
  • Clinical Pharmacology
  • Genomics

Background:

  • The Drug Rediscovery Protocol (DRUP) is a Dutch, pan-cancer clinical trial.
  • It focuses on patients with advanced or metastatic cancer who have exhausted standard treatment options.

Purpose of the Study:

  • To investigate the efficacy and safety of targeted and immunotherapies used off-label.
  • To provide access to novel anticancer treatments for patients with specific molecular genomic variants.

Main Methods:

  • Nonrandomized clinical trial design.
  • Patient eligibility requires advanced cancer, no standard options, and a targetable molecular genomic variant.
  • Primary endpoint is clinical benefit, defined as objective response or stable disease for at least 16 weeks.

Main Results:

  • Over 1,500 patients have been treated in the DRUP trial.
  • The overall clinical benefit rate (CBR) is 33%.
  • Nivolumab showed a 63% CBR in microsatellite instable tumors, while CDK4/6 inhibitors had a 15% CBR.

Conclusions:

  • DRUP successfully improves patient access to off-label therapies in the Netherlands and Europe.
  • Expansion of similar trials promotes precision oncology and equitable access to cancer treatments.

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