Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. Traditionally doctors decide on how to treat a cancer by looking at what type of cancer it is.
Background to the trial
We know that this works for many people but not for everyone. This could be because there are slight differences in the cancer cells from person to person, even if they have the same type of cancer. This is particularly true of lung cancer, where the changes to the genes in the cancer cells are different from person to person.
This means that each person with lung cancer will have a range of changes in their genes, unique to their cancer, that allow their cancer cells to grow and divide. Genes are coded messages that tell cells how to behave. If a gene is changed it can allow cancer cells to grow.
Identifying the gene changes will allow doctors to specifically target these gene changes, and try to kill the cancer cells, or stop them growing. Matching the treatment to the genetic changes in cancer cells is called ‘stratified medicine’.
About the trial
The National Lung Matrix Trial is a large clinical trial (research study) with sites across the United Kingdom, which is testing several new treatments for patients with non-small cell lung cancer.
The patients taking part in this trial have already agreed to have their cancer tested as part of Cancer Research UK’s Stratified Medicine Programme 2 (SMP2) to look for any gene changes in their cancer cells.
In the National Lung Matrix trial, patients will be offered a particular treatment depending on the specific gene change present within their cancer cells. These treatments are intended to “target” the specific gene change.
This is a phase II trial. This means most of the drugs being used in the trial are not licensed to specifically treat these gene changes, and by carrying out the trial we want to find out:
- If the treatment works well enough to test in a larger phase III trial with more patients
- Which types of cancer the treatment works for
- More information about side effects
- More information about the best dose to use.
Trial patients will be placed into different groups (referred to as arms), depending on the specific drug they receive and also into different sub-groups (referred to as cohorts) depending on the type of non-small cell lung cancer and gene changes that they have.
- Patients in Arm A receive an oral drug called AZD4547 (this Arm is now closed to recruitment)
- Patients in Arm B receive an oral drug called vistusertib
- Patients in Arm C receive an oral drug called palbociclib
- Patients in Arm D receive an oral drug called crizotinib
- Patients in Arm E receive an oral drug called selumetinib in combination with a chemotherapy drug called docetaxel
- Patients in Arm F receive an oral drug called AZD5363 (this Arm is now closed to recruitment)
- Patients in Arm G receive an oral drug called osimertinib (this Arm is now closed to recruitment)
- Patients in Arm H receive an oral drug called sitravatinib (this Arm is now closed to recruitment)
- Patients in Arm J receive an oral drug called AZD6738 and an intravenous drug called durvalumab
If patients don’t have a gene change which can be matched to one of the above drugs, but enough genes were successfully tested by the Technology Hub under SMP2, they can be placed in the ‘no actionable changes’ arm (Arm NA):
- Patients in Arm NA Cohort NA1 receive an intravenous drug called durvalumab (this Arm is now closed to recruitment)
- We would like to see how well each treatment works against certain specific gene changes, to find out more information about tumour shrinkage and to see how safe the drug is. We will be using Computed Tomography (CT) scans which will be used to see the tumour and to measure if it is getting bigger or smaller.
- We would like to collect blood samples so that we can look at changes in tiny amounts of tumour (ctDNA) that are present in patient’s blood before, during and after treatment. This may help us identify which changes in the tumour DNA are linked to drug resistance.
- We would like to collect tissue samples from a patient’s tumour before and after treatment. This is to help us understand why some people benefit from treatment and others do not.
- For more information on how to get involved, and for a list of which hospitals are currently recruiting patients to this trial, please visit how to get involved.