publication date: Jul. 28, 2017

Pediatric MATCH starts to accrue children with recurrent and refractory cancers

By Paul Goldberg

NCI and the Children’s Oncology Group opened enrollment in Pediatric Molecular Analysis for Therapy Choice—Pediatric MATCH—a long-awaited precision medicine trial.

Pediatric MATCH, a series of single-arm phase II trials, will seek to screen between 200 and 300 patients per year, with the goal of screening 1,000 patients over four years, assigning children to therapies that target genomic characteristics of their diseases.

The pediatric trial is being opened just as its adult counterpart is being extended and expanded to a larger population (The Cancer Letter, July 7). Trials like MATCH can be extended for as long as necessary to fill sub-protocols focused on rare variants.

The protocol for Pediatric MATCH is posted here.

The distinctions between Pediatric MATCH and its adult counterpart point to biological differences between pediatric and adult cancer and the fundamentally divergent ways in which children and adults are treated in the U.S.

In childhood cancer, mutations tend to be less complex than in adult cancer, and when they exist, they usually drive the disease. But they are also less common. The adult version of the trial, called NCI-MATCH, is finding a “match,” or an actionable mutation, in one screened patient out of five. Pediatric MATCH is designed to get a match in one of ten patients screened.

In adult cancer, the proportion of patients in clinical trials is well under 5 percent. In pediatric cancer, 90 percent of patients are treated at institutions that are part of Children’s Oncology Group.

This means that information stemming from signals found in Pediatric MATCH could be distributed nationally and internationally, making it easier to expand cohorts. And, using the same mechanisms, COG can influence standards of care literally overnight.

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