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EDWARD S. KIM<br />

TABLE 1. Selected Umbrella and Master Trials<br />

Title Short Name Sponsor Accrual Dates<br />

Biomarker-Integrated BATTLE MD Anderson Cancer<br />

Approaches of Targeted<br />

Center<br />

Therapy for Lung Cancer<br />

Elimination<br />

BATTLE-2 Program: A<br />

Biomarker-Integrated<br />

Targeted Therapy Study<br />

BATTLE-2<br />

MD Anderson Cancer<br />

Center<br />

Lung Cancer Master Protocol Lung-MAP Southwest Oncology<br />

Group<br />

Investigation of Serial Studies<br />

to Predict Your Therapeutic<br />

Response with Imaging And<br />

Molecular Analysis 1<br />

Investigation of Serial Studies<br />

to Predict Your Therapeutic<br />

Response with Imaging And<br />

Molecular Analysis 2<br />

Molecular Analysis for Therapy<br />

Choice<br />

Initiative for Molecular Profiling<br />

in Advanced Cancer Therapy<br />

(IMPACT) Trial, An Umbrella<br />

Protocol<br />

Molecular Profiling-Based<br />

Assignment of Cancer<br />

Therapeutics<br />

Adjuvant Lung Cancer<br />

Enrichment Marker<br />

Identification and<br />

Sequencing Trial<br />

I-SPY1<br />

I-SPY2<br />

NCI MATCH<br />

IMPACT<br />

NCI MPACT<br />

ALCHEMIST<br />

National Cancer<br />

Institute<br />

QuantumLeap<br />

Healthcare<br />

Collaborative<br />

National Cancer<br />

Institute<br />

MD Anderson Cancer<br />

Center<br />

National Cancer<br />

Institute<br />

National Cancer<br />

Institute<br />

Estimated<br />

Enrollment Cancer Types Treatment Biomarkers<br />

2006-2015 250 Non-small cell<br />

lung<br />

2011-2017 450 Non-small cell<br />

lung<br />

2014-2022 Up to 10,000<br />

screened<br />

Squamous cell<br />

lung<br />

Erlotinib, sorafenib, vandetanib,<br />

erlotinib bexarotene<br />

Erlotinib, AZD6244, MK-2206,<br />

sorafenib<br />

MEDI4736, GDC-0032, palbociclib<br />

isethionate, AZD4547,<br />

rilotumumab, docetaxel,<br />

erlotinib hydrochloride<br />

2002-2010 356 Stage II-III breast Standard neoadjuvant<br />

anthracycline-based<br />

chemotherapy, with or<br />

without a taxane<br />

2010-2015 800 Locally advanced<br />

breast<br />

Opening early<br />

2015<br />

Up to 3,000<br />

screened for<br />

biomarkers,<br />

approximately<br />

1,000 treated<br />

2009-2016 Approximately<br />

5,000<br />

2014-2017 700 to be screened,<br />

180 to be<br />

enrolled on<br />

treatment<br />

2014-2020 Up to 8,000<br />

screened<br />

Advanced solid<br />

tumors,<br />

lymphoma<br />

Advanced<br />

cancers<br />

Advanced<br />

cancers<br />

Early-stage<br />

non-small<br />

cell lung<br />

Standard therapy, AMG 386,<br />

AMG 479 (ganitumab) <br />

metformin, MK-2206 with or<br />

without trastuzumab, AMG<br />

386 trastuzumab, T-DM1<br />

pertuzumab, pertuzumab<br />

trastuzumab, ganetespib<br />

20-25 targeted agents (e.g.,<br />

imatinib, erlotinib, crizotinib,<br />

trastuzumab, vemurafenib)<br />

None<br />

Temozolomide, everolimus,<br />

carboplatin, trametinib<br />

DMSO, ABT-888, MK-1775<br />

Erlotinib hydrochloride,<br />

crizotinib<br />

EGFR, KRAS, BRAF, CCND1,<br />

VEGF, VEGFR-2, RXRs,<br />

cyclin D-1<br />

EGFR, KRAS, EML4/ALK<br />

PIK3CA, CCND1, D2, CDK4,<br />

FGFR<br />

Hormone and HER2<br />

expression<br />

Hormone and HER2<br />

expression<br />

EGFR, HER2, MET, BRAF,<br />

NF1, GNAQ, GNA11,<br />

TSC1/2, PTEN, Patch,<br />

NF2, ALK, ROS, FGFR<br />

EGFR, VEGF, HIF-1,<br />

PI3K, RAS, RAF, MEK,<br />

cytokines, interleukins<br />

DNA repair pathways,<br />

PI3K, or RAS/RAF/MEK<br />

EGFR, ALK<br />

Safeway Foundation, Biomarkers Consortium, Quintiles,<br />

and QuantumLeap Health Care Collaborative. The goal of<br />

I-SPY 1 was to identify predictors of response to neoadjuvant<br />

chemotherapy for women with stage II/III cancer. A total of<br />

356 women were enrolled; biomarker information and MRI<br />

results were obtained. Researchers found that certain tumor<br />

profıles responded better than others to particular drugs. Results<br />

from I-SPY 1 guided the design of I-SPY 2, an adaptive,<br />

randomized trial that uses early data to guide treatment decisions<br />

for those enrolled later in the trial. Approximately 800<br />

women will be enrolled in this trial of multiple drugs. 12<br />

ALCHEMIST<br />

The NCI has launched initiatives to study patients with<br />

unique biomarkers and targeted therapy in both early- and<br />

advanced-stage cancer settings. The Adjuvant Lung Cancer<br />

Enrichment Marker Identifıcation and Sequencing Trial<br />

(ALCHEMIST) series is focused on patients diagnosed with<br />

early-stage lung cancer. The series of trials consists of a<br />

screening trial and two treatment trials (EGFR-targeted therapies<br />

and ALK-targeted therapies). Approximately 6,000 to<br />

8,000 patients will be enrolled in the screening trial over the<br />

next 5 to 6 years with the goal of determining if selection of<br />

therapy based on these molecular markers leads to improved<br />

survival. Tumor biopsies from these patients will be evaluated<br />

for EGFR and ALK abnormalities. Patients whose tumors harbor<br />

one of these mutations will be directed into the appropriate<br />

biologic treatment trial (erlotinib if EGFR is mutated and crizotinib<br />

if ALK is abnormal vs. placebo). Each treatment trial is expected<br />

to enroll approximately 400 patients. 13<br />

MASTER STUDIES<br />

NCI MATCH<br />

Another NCI-sponsored study, NCI MATCH (The NCI Molecular<br />

Analysis for Therapy Choice Trial), will enroll patients<br />

with advanced solid tumors (gastrointestinal stromal<br />

tumor, NSCLC, breast, gastric, melanoma, thyroid) and lym-<br />

24 2015 ASCO EDUCATIONAL BOOK | asco.org/edbook

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