Nilofer Azad, MD and April Salama, MD
Now Enrolling: ECOG-ACRIN Opens a New NCI-MATCH Treatment Arm for dMMR and LAG-3-Positive Cancers as it Continues to Locate Patients with BRAF Mutations
April 15, 2022

From the Co-Chairs, April 2022

Dr. O'Dwyer and Dr. Schnall

By Peter J. O’Dwyer, MD (left)
and Mitchell D. Schnall, MD, PhD

As spring unfolds and the pandemic abates, at least for now, we turn to a flurry of events that may have long-term implications for our research and how it is conducted. The passage of the $1.5 trillion federal spending bill in late March included funding for both the National Cancer Institute (NCI) and for a new health care research agency, Advanced Research Projects Agency for Health (ARPA-H). The formal passage of NCI funding was important, since funding under a continuing resolution actually would have resulted in about a 10% cut across the board. The approved Act provides stable funding of existing priorities, but without an increase that would permit a rise in the R01 payline (currently 8-9%), a benchmark for the robustness of the national cancer research effort.

This NCI funding outcome is expected to be offset, in part, by the funding for ARPA-H. Modeled on the Defense Advanced Research Projects Agency (DARPA), a program of innovative public-private high-impact research in the Defense Department, ARPA-H will be a new agency with a similar design in health care research. It is understood that the Administration’s priorities give prominence to cancer research, and that at least a portion of the $1 billion initial investment in ARPA-H will be to expand research in our field. As a new agency though, and with its location projected to be outside the Capital Beltway, it seems likely that funding opportunities may be a year or so in the future. To us that seems like an opportunity to plan, and to incorporate sizeable projects in our thinking.

This issue also contains a reminder that the NCI-MATCH trial is open with two arms remaining. We are eager to fill the remainder of the BRAF V600 substudy—as an uncommon mutation in several diseases, and with an apparent disease-independent (except colon cancer) activity of pathway inhibition with dabrafenib/trametinib, the addition of participants to this arm can greatly help patients get access to the therapy. The second arm is the combination of nivolumab and relatlimab for patients with MSI-H tumor whose disease progresses on PD-1 inhibition alone. The recent results of this combination in melanoma (Tawbi HA, Schadendorf D, Lipson EJ, et al. Relatlimab and nivolumab versus nivolumab in untreated advanced melanoma. New England Journal of Medicine. 2022;386(1):24-34. doi:10.1056/nejmoa2109970) project this substudy too to be a highly promising treatment in an uncommon disease.

Finally, we look forward very much to seeing you in Chicago in May for our first in-person meeting in a long while. The schedule of events for this meeting will be slightly curtailed given the need for virtual access to some of the sessions, but the key elements will be well-represented. The AACR Annual Meeting, currently in progress at the time of writing, has 80% on-site attendance, a testament to their approach to ensuring safety, and to confidence in the current status of the pandemic.

On the meeting agenda we draw your attention to two sessions that we hope will be of high interest and impact in our future activities. First, led by ECOG-ACRIN Vice Chair, Dr. Al Benson, the Robert L. Comis, MD Translational Science Symposium will address the issues surrounding incorporation of Real-World Data into our thinking. The possibilities of this research are relevant to cancer centers, and especially to community oncologists. The agenda includes noted experts in all facets of this area of emerging importance, and with a one-hour panel discussion is sure to be a dynamic and important introduction of these concepts in our Group. The second is the General Session, during which several topics are featured. As you have probably seen, we have given attention in recent years to the General Session agenda, especially for its potential to introduce some new research to our membership. This year we will present an important ECOG-ACRIN melanoma trial, as well as a perspective on the future development of immune therapies in melanoma. We will also address the very timely issue of ctDNA tests and their availability to the public. There are research plans afoot that we will introduce, along with consideration of what the oncologist’s response will be when presented with a positive test by an otherwise-well patient. We urge attendance and participation in both of these important sessions. We wish you safe travels—bring lots of ideas and a mask (encouraged but not required)!

Read the April 2022 issue here.

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