myeloMATCH to use genomics to enroll patients into target-based leukemia trials
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Key takeaways:
- myeloMATCH will quickly evaluate genomic profiles of adults with leukemia and enroll them in a matched clinical trial.
- Patients will be reevaluated and moved to subsequent trials to target residual disease.
A new initiative to rapidly place individuals with acute myeloid leukemia or myelodysplastic syndrome in clinical trials based on their genomic profiles has opened in the United States and Canada.
The myeloMATCH program will enroll patients into different studies as their cancer progresses, aiming to use precision medicine approaches to target residual disease.
“We have so many large phase 3 trials that have turned out negative, and this is a drain on resources — both the number of patients and the time and opportunity loss,” Richard F. Little, MD, NCI coordinator for myeloMATCH and head of hematologic, HIV and stem cell therapeutics for the clinical investigations branch of NCI’s Cancer Therapy Evaluation Program, said during a press conference. “We believe myeloMATCH has the chance to change this so that we can then identify the most promising phase 3 trials and thus accelerate the identification of effective treatments that would then become available to patients.”
The Alliance for Clinical Trials in Oncology, Canadian Cancer Trials Group, ECOG-ACRIN Cancer Research Group and SWOG Cancer Research Network will work together to design trials within the NCI National Clinical Trials Network. They have activated 143 clinical sites so far and many more are expected.
“The NCI National Clinical Trials Network is a huge network, which also includes community sites,” Olatoyosi Odenike, MD, chair of the myelodysplastic clinical group for myeloMATCH and director of the leukemia program at University of Chicago, said during the press conference. “It’s amazing to be able to actually bring this kind of 21st century precision medicine effort very close to where patients may live, and thereby really provide access to many who might not otherwise been able to access those kinds of efforts.”
Newly diagnosed participants will be screened and, based on results of genomic profiling — which will be obtained within 72 hours — will be assigned to an appropriate clinical trial.
“When samples are obtained at outside sites, we’re going to rely on the local pathologists to look under the microscope and make the diagnosis of acute myeloid leukemia, and then samples are sent out to the specialty labs to do more tests that kind of fine-tune things for risk stratification and treatment assignment,” Jerald Radich, MD, co-chair of myeloMATCH laboratory assays and informatics, and professor in the translational science and therapeutics division at Fred Hutch Cancer Center, said during the press conference.
Patients will continue to be reevaluated and can be transferred to different trials to receive the next appropriate treatment based on genomics.
Adults who do not match for a study will receive standard-of-care treatment and will be reevaluated later to see if they fit another trial.
“Ultimately, we hope to have patients who will be in a place where they’ve completed all their therapy,” Little said. “There may be residual disease that would be responsible for a relapse, and we hope to be able to identify what that is and target it.”
The typical study design will be randomized phase 2 trials. Each arm generally will have 25 to 60 participants, with results expected in 1 to 3 years.
“Early endpoints that can identify the relative effect of the treatments among the arms are used,” Little said. “This can inform what are the most promising approaches for more definitive development.”
Researchers expect to accrue 700 patients by October 2025. They have screened around 80 thus far, and multiple individuals already have been enrolled.
“myeloMATCH is a fantastic opportunity to bring the advances of drug development, genetics and diagnostics to large numbers of patients with AML or [myelodysplastic syndrome],” Radich said in a press release. “What we learn from myeloMATCH may have a major impact on the future of clinical trials in leukemia and beyond.”
Reference:
- myeloMATCH precision medicine trials in myeloid leukemias open to patient enrollment across U.S. and Canada (press release). Published Oct. 23, 2024. Accessed Oct. 23, 2024.
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