Doctors and researchers have long touted the benefits of personalized medicine – establishing a treatment plan based on a patient’s specific disease characteristics – for mesothelioma patients. Treatment targeted to a patient’s particular genetic traits optimizes the potential for success of the treatment. Now, the National Cancer Institute is promoting its nationwide clinical trial that is open to thousands of cancer patients for treatments based on the genetic makeup of their tumors.
The NCI is offering an unprecedented opportunity to patients suffering from cancer that continues to grow, despite previous treatment, through its NCI-Molecular Analysis for Therapy Choice (NCI-MATCH) clinical trial. According to the NCI’s website, the trial will analyze patients’ tumors to determine whether they contain genetic abnormalities for which a targeted drug exists and assign treatment based on the abnormality.
The goal is to determine whether treating cancers according to its molecular abnormalities will show evidence of effectiveness. The trial will evaluate if treating patients with drugs or drug combinations that target the gene abnormalities believed to be driving their cancer will shrink their cancer regardless of the cancer type, according to the NCI. Another goal of the trial is for at least 25 percent of the total patients enrolled to have rare cancers.
Mesothelioma is rare cancer that has been shown to harbor some of the same genetic abnormalities as lung cancer, such as EGFR and HER2, that are included in the NCI-MATCH Arms in the trial. Pleural mesothelioma is a cancer of the mesothelial cells, caused by breathing in asbestos fibers that become lodged in the thin membrane that lines and encases the lungs. Clinical trials offer patients with the incurable cancer their best chance at survival.
Patients began enrolling in August 2015. Currently, there are 24 treatment arms available open to 35 or more patients. Patients will eventually have access to 20 different drugs or drug combinations, both approved and experimental. Each treatment targets a specific gene mutation, and each patient will be matched with a therapy that targets a molecular abnormality in his or her tumor. For this trial, patients will not be treated according to therapies focused on the origin of cancer, rather they will be treated according to the biomarkers that cause the cancer to grow.
“NCI-MATCH is a unique, ground-breaking trial,” said Doug Lowy, M.D., NCI acting director, in a 2015 press release announcing the trial. “It is the first study in oncology that incorporates all of the tenets of precision medicine.”
Personalized medicine is the wave of the future, and NCI hopes to prove this out with this trial. With an influx of money from President Obama’s Precision Medicine Initiative, the number of patient screenings increased from 5,000 to 6,000, and whole exome sequencing and RNA sequencing on approximately 1,000 patients treated with targeted agents is now part of the trial.
Mesothelioma is diagnosed in close to 3,000 Americans each year. There is no cure for the cancer, and there are limited options available for treating patients. According to the NIH, clinical trials are at the heart of all medical advances. Clinical trials offer mesothelioma patients hope that a cure is on the horizon.
“There are no other cancer clinical trials of this size and scope that truly bring the promise of targeted treatment to patients whose cancers have specific genetic abnormalities,” said Lowy. “It holds the potential to transform cancer care.”
Enrollment in NCI-MATCH will be available through 2,400 sites participating in the National Clinical Trials Network.
Photo credit: National Cancer Institute