The National Cancer Institute (NCI) has launched ComboMATCH, a large precision medicine cancer initiative that aims to test the effectiveness of new drug combinations in treating specific tumor alterations. ComboMATCH is the largest initiative of its kind, focusing on combinations of cancer drugs guided by tumor biology. Its objective is to identify promising treatments that can advance to larger clinical trials beyond ComboMATCH. This collaborative effort involves multiple phase 2 treatment trials, evaluating combinations of targeted drugs or a targeted drug with chemotherapy. Some trials will include patients with specific changes in their cancer cells, regardless of cancer type, while others will enroll patients with specific cancer types.
The initiative recognizes that most current treatments are not determined by genomic factors. By utilizing genomic abnormalities to determine effective treatment combinations, ComboMATCH aims to improve patient outcomes. It builds upon the success of NCI-MATCH, a precision medicine clinical trial that assigned treatments based on genetic changes in tumors rather than cancer type. However, resistance to single drugs became an issue, leading ComboMATCH to attack both the genetic driver and mechanisms of resistance to achieve more durable clinical responses.
ComboMATCH will include both FDA-approved drugs and investigational agents contributed by pharmaceutical companies. The challenge lies in prioritizing the most promising drug combinations out of the hundreds of thousands of potential options. The coordination effort is led by the ECOG-ACRIN Cancer Research Group, and all five U.S. clinical trial groups within NCI's National Clinical Trials Network will conduct the treatment trials.
Patients with locally advanced or metastatic solid tumors will be identified through genomic testing, which has become standard in cancer care. Referrals from doctors and identification by designated labs will lead to eligibility screening for participation in ComboMATCH. Patients matched to a trial will provide a pretreatment tumor biopsy specimen for genomic profiling. Currently, three ComboMATCH trials are open for enrollment, and more trials will be added over time.
While NCI-MATCH excluded children, ComboMATCH will include pediatric patients in some trials. NCI plans to launch two additional precision medicine cancer treatment trials: ImmunoMATCH, focused on improving responses to targeted treatments using immunotherapy, and MyeloMATCH, testing treatments based on genetic changes in the cancer cells of people with acute myeloid leukemia or myelodysplastic syndromes.
The NCI leads the National Cancer Program, working to reduce cancer prevalence and improve the lives of patients and families through research, intervention development, and researcher training. The NIH, as the nation's medical research agency, supports basic, clinical, and translational medical research to investigate the causes, treatments, and cures for both common and rare diseases.
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