Nearly seven years ago, the ECOG-ACRIN Cancer Research Group (ECOG-ACRIN) and the National Cancer Institute (NCI) jointly launched a very different kind of cancer study. The NCI-MATCH precision medicine cancer trial sought to match genetic abnormalities driving patients' tumors with approved or experimental drugs targeting those molecular defects. The type of cancer did not matter.
At the time of development, the size and scope of NCI-MATCH had never before been attempted. It remains the largest precision medicine cancer trial to date, with 39 unique treatment arms. It is the first national-scale clinical trial in the United States to incorporate centralized diagnostic testing and geographically distributed clinical investigation of dozens of treatment options in parallel (Flaherty KT. J Clin Oncol. October 2020).
It was an enormous undertaking to develop the necessary infrastructure for the national trial across all cancers. Once the trial opened, ECOG-ACRIN's role expanded to include coordinating the genetic testing and supporting trial sites with training, laboratory services, trial assignments, biostatistical support, data management, auditing, quality control, and public awareness.
Together, ECOG-ACRIN and the NCI have built a vast knowledge base and laid the groundwork in multiple areas that are defined in several publications and summarized here:
To researchers’ knowledge, NCI-MATCH is the first attempt to establish the likelihood of identifying targeted investigational therapeutic options within a clinical trial cohort representative of the population of patients with advanced refractory cancers (Flaherty KT. J Clin Oncol. October 2020).
"The depth and breadth of expertise among the investigators and staff involved in NCI-MATCH is unprecedented and includes hundreds of translational scientists, clinical oncologists, community practitioners, research personnel, and advocates, all with deep experience in clinical trials," said Peter J. O'Dwyer, MD, group co-chair of ECOG-ACRIN, which is co-leading the trial with the NCI.
Ultimately, NCI-MATCH is a demonstration of leadership and cooperation among ECOG-ACRIN, the NCI, the NCI Clinical Trials Network (NCTN) cooperative groups, pharmaceutical and biotechnology companies, genomic testing laboratories, participating clinical sites, and physicians. In addition, patient advocates were engaged in developing the trial and are giving input on its implementation.
"NCI-MATCH is influencing how cancer clinical trials will be designed and conducted in the future," said Lyndsay Harris, MD, a medical oncologist at the NCI, Associate Director of the NCI's Cancer Diagnosis Program, and NCI study co-chair for the overall NCI-MATCH trial.
ECOG-ACRIN is continuing to offer its expertise in precision medicine cancer trials through its Developmental Therapeutics Committee, led by Keith T. Flaherty, MD (Massachusetts General Hospital Cancer Center). Recently, this committee expanded and formed a new Genomics Subcommittee and named Kristen Spencer, DO, MPH (Rutgers Cancer Institute of New Jersey), as its first chair. The committee has about 20 members currently, who plan to develop molecularly-informed concepts—particularly combination concepts—to move forward through ECOG-ACRIN and PrECOG.
Dr. Spencer explained in a recent interview that the combination concepts could include immunotherapy, targeted therapies, chemotherapy, and radiation therapy. Members actively engage with industry partners and help them develop these types of concepts with novel compounds—particularly in areas like rare tumor subtypes.
Read this companion article 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.
Learn more about NCI-MATCH at ecog-acrin.org
Questions? Send an email to the trial team.
NCI-MATCH is sponsored by the NCI, part of the National Institutes of Health. ECOG-ACRIN is co-leading the trial with the NCI. Other NCI-funded network groups are participating: Alliance for Clinical Trials in Oncology, Children’s Oncology Group, NRG Oncology, and SWOG Cancer Research Network.