Early Results of NCI-Match Trial Bring Hope of Better Treatment Options for Mesothelioma Patients

In March 2017, Mesothelioma Help reported on the NCI-Molecular Analysis for Therapy Choice (NCI-MATCH) clinical trial that was opened to thousands of cancer patients for treatments based on the genetic makeup of their tumors. Last week, researchers presented early results of the “largest precision medicine trial of its kind” that point to increased interest in personalized treatment for all cancer patients, including mesothelioma patients.

One target for the trial is for at least 25 percent of the total patients enrolled to have rare or uncommon cancers, and, according to the NCI-Match website, the trial has exceeded this goal with about 60% of the patients having cancers other than colon, rectal, breast, non-small cell lung, or prostate. According to a March 2017 report, at that time, ten mesothelioma patients had been screened and three had been treated. Mesothelioma is a rare cancer caused by past exposure to asbestos.

Positive results from the trial, all warranting additional study of the drugs, include: The drug taselisib used with mutations in the PIK3CA gene resulted in 24 percent of the patients achieving progression-free survival lasting greater than six months, even in aggressive and rare cancers; the drug ado-trastuzumab emtansine (T-DM1) studied in patients with HER2-overexpressing tumors showed at least 30 percent shrinkage of the tumor in rare cancer patients; the drug AZD4547 used in patients with mutations of the FGFR pathway led to a partial response in ten percent of the patients.

“The outcomes data being released today from this groundbreaking precision medicine trial are an exciting step for NCI-MATCH,” said Lyndsay Harris, M.D., of NCI’s Cancer Diagnosis Program and NCI study chair, in the June 4 press release from the National Institutes of Health.

Trial Goals Focus on Biomarkers and Personalized Care

The NCI-MATCH trial that turns to targeted therapy to improve survival has a goal of at least 16% of the patients in an arm to have tumor shrinkage, a number the researchers say will make the mesothelioma treatment “promising,” according to the trial’s website. They also will collect percentage numbers for patients who experience a progression-free survival of at least six months, as well as looking at various other metrics. Results have been reported on four arms, but, the researchers say, these results “are the first of a large trove of data to come from nearly 40 treatment arms.”

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Lyndsay Harris, M.D., NCI’s Cancer Diagnosis Program

“These findings represent a large collection of data … and they will have important implications for future precision medicine trials.”

The NCI-MATCH trial assigns patient treatments based on the genetic changes found in their tumors through genomic sequencing and other tests. Patients then receive a treatment that targets those genetic mutations, regardless of their cancer type, with a goal to determine whether treating cancer based on these specific genetic changes is effective.

Find out about the IMPACT clinical trial – another targeted therapy trial.

“By focusing our investigational effort on new biomarker-guided therapies in understudied cancer types, we have accelerated the opportunity to find signals of efficacy,” said ECOG-ACRIN study chair Keith T. Flaherty, M.D., a medical oncologist at Massachusetts General Hospital Cancer Center in Boston. NCI-MATCH is coordinated by the ECOG-ACRIN Cancer Research Group.

The results were presented at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago last week.

Nearly 3,000 Americans are diagnosed with mesothelioma each year. There is no cure for the cancer, but treatments intended to go after the unique characteristics of the disease have shown promise. Oncologists and mesothelioma patients are hopeful that this trial will bring personalized  care to the forefront of treatment strategies.

Visit NCI-MATCH for more information about the clinical trial.

Sources:

• NCI-Match website
  https://www.cancer.gov/about-cancer/treatment/clinical-trials/nci-supported/nci-match
• ECOG-ACRIN Cancer Research Group
  https://www.nih.gov/news-events/news-releases/nci-match-precision-medicine-clinical-trial-releases-new-findings-strengthens-path-forward-targeted-cancer-therapies
• National Institutes of Health
  https://www.nih.gov/news-events/news-releases/nci-match-precision-medicine-clinical-trial-releases-new-findings-strengthens-path-forward-targeted-cancer-therapies
• March 2017 report”
  https://deainfo.nci.nih.gov/advisory/bsa/0317/Doroshow.pdf