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Findings from three clinical trial arms of precision medicine released at 2018 (at ASCO meeting in Chicago) on the study developed by NCI and ECOG-ACRIN:
: NCI-MATCH, a phase 2 clinical trial, seeks to determine whether targeted therapies for people whose tumors have certain gene mutations will be effective regardless of their cancer type, using ...

 Purpose: NCI-MATCH, a phase 2 clinical trial, seeks to determine whether targeted therapies for people whose tumors have certain gene mutations will be effective regardless of their cancer type, using DNA sequencing test to identify gene mutations in patients’ tumors.

These tests look for mutations in 143 genes associated with cancer that can be targeted by one of the drugs being studied in the trial.
Patient criteria:Adults who have solid tumors, lymphoma, or myeloma that have progressed on standard treatment or mainly rare cancers for which there is no standard treatment. Many of the patients (about 50%) in these three last arms had been treated with more than three lines of therapy before entering the trial.
 
Results (so far):
·        The first arm (Arm Z1D), released in Nov 2017 at the Society for Immunotherapy of Cancer annual meeting, and showed that the drug nivolumab has promising activity in mismatch repair–deficient non-colorectal cancers.
  • Arm I studied the drug taselisib in 65 patients with mutations in the PIK3CA gene. There were no objective responses to the drug, meaning the tumors did not shrink substantially. However, 24 percent of the patients had progression-free survival—or prolonged stable disease—of greater than six months. This prolonged stable disease was seen even in patients with aggressive cancer types, including lung cancer and cholangiocarcinoma (bile duct) cancer.
    • The observation of prolonged disease control in these cancer types suggests the drug warrants further research.
  • In Arm Q, the drug ado-trastuzumab emtansine (T-DM1) was studied in patients with HER2-overexpressing tumors, excluding breast and gastric/gastroesophageal junction cancers. Partial responses (at least 30 percent shrinkage of the tumor) were seen in three of the 37 patients, each of whom had a rare cancer.
    • The researchers concluded that the findings warrant further study, particularly in certain rare cancers.
  • Arm W tested the drug AZD4547 in 50 patients with mutations in the FGFR pathway. 10 percent of patients had a partial response.
    • This suggests that these mutations may be particularly sensitive to the drug, warranting further studies in tumors harboring these fusions.
It suggests that future studies in populations with earlier-stage disease could potentially see more responses.