The screening method used in the study could be applied beyond clinical trials, Dr Flaherty said. “The molecular screening approach that we used in NCI-MATCH is certainly ready for prime time; for use in all types of oncology practices,” he wrote in an email. “Next generation sequencing platforms like the one that we used are available through several commercial laboratories in addition to a number of large, academic medical centers who perform testing within their hospital laboratories.”

Applying the methodology used in the trial more broadly may also help to boost enrollment in cancer clinical trials, said Vivek Subbiah, MD, an associate professor in the investigational cancer therapeutics department at the University of Texas MD Anderson Cancer Center in Houston. “Less than 5% of patients [with cancer] are enrolled in clinical trials,” said Dr Subbiah, who was not involved in the new research. “The only way we can advance cancer medicine and cancer therapy is enroll patients in clinical trials. And the more we involve patients in clinical trials, especially in precision oncology clinical trials, the more we can be closer to moving the cancer needle.”

Razelle Kurzrock, MD, distinguished professor of medicine at the University of California San Diego School of Medicine, California, who was not involved in the new study, applauded the authors’ ability to put together what she called an “enormous trial” conducted at a large number of sites. However, she said that the paper lacked information on patient outcomes. “I think that in the year 2020, we should know about patient outcomes in a publication,” she said.

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“What I would have liked to know is what happens to these patients,” Dr Kurzrock said. “Did they respond? What was their progression-free survival? What was their overall survival?”

In response to Dr Kurzrock’s comments, Dr Flaherty said that patient outcome data from some of the individual arms in the trial had been published by the time the researchers submitted their manuscript to the journal, and more such data were published while the manuscript was undergoing review and revision. Additional outcome data will be published in the future, he said.

“We will continue to publish the individual arms in a rolling fashion,” Dr Flaherty wrote in an email. “As some of the arms target very rare subpopulations and are taking longer to accrue, we did not want to withhold this genomic landscape analysis while waiting for those remaining arms. We will certainly analyze and publish the outcomes for the whole study population in a separate paper, but are simply trying to get important components out as the data are ready.”

In response, Dr Kurzrock said that the information provided by Dr Flaherty addressed her concerns about the lack of patient outcome data in the new paper.

Disclosures: Some authors have received honoraria or research funding from the pharmaceutical industry. Please refer to the original paper for a full list of disclosures.

References

  1. Flaherty KT, Gray RJ, Chen AP, et al. Molecular landscape and actionable alterations in a genomically guided cancer clinical trial: National Cancer Institute molecular analysis for therapy choice (NCI-MATCH). J Clin Oncol. Published online October 13, 2020. doi:10.1200/JCO.19.03010
  2. Unger JM, Blanke CD, LeBlanc M, Hershman DL. Association of the coronavirus disease 2019 (COVID-19) outbreak with enrollment in cancer clinical trials. JAMA Netw Open. 2020;3(6):e2010651. doi:10.1001/jamanetworkopen.2020.10651
  3. Jhaveri KL, Wang XV, Makker V, et al. Ado-trastuzumab emtansine (T-DM1) in patients with HER2-amplified tumors excluding breast and gastric/gastroesophageal junction (GEJ) adenocarcinomas: results from the NCI-MATCH trial (EAY131) subprotocol. Ann Oncol. 2019;30(11):1821-1830. doi:10.1093/annonc/mdz291
  4. Azad NS, Gray RJ, Overman MJ, et al. Nivolumab is effective in mismatch repair-deficient noncolorectal cancers: Results from arm Z1D-A subprotocol of the NCI-MATCH (EAY131) study. J Clin Oncol. 2020;38(3):214-222. doi:10.1200/JCO.19.00818
  5. Johnson DB, Zhao F, Noel M, et al. Trametinib activity in patients with solid tumors and lymphomas harboring BRAF non-V600 mutations or fusions: Results from NCI-MATCH (EAY131). Clin Cancer Res. 2020;26(8):1812-1819. doi:10.1158/1078-0432.CCR-19-3443
  6. Chae YK, Hong F, Vaklavas C, et al. Phase II study of AZD4547 in patients with tumors harboring aberrations in the FGFR pathway: Results from the NCI-MATCH trial (EAY131) subprotocol W. J Clin Oncol. 2020;38(21):2407-2417. doi:10.1200/JCO.19.02630
  7. Salama AKS, Li S, Macrae ER, et al. Dabrafenib and trametinib in patients with tumors with BRAFV600E mutations: Results of the NCI-MATCH trial subprotocol H [published online ahead of print, 2020 Aug 6]. J Clin Oncol. 2020;JCO2000762. doi:10.1200/JCO.20.00762

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