A clinical trial for advanced lung cancer that could incorporate up to 14 different drugs tested in parallel will open later this year under a partnership between Cancer Research UK (CR UK) and two pharmaceutical companies, AstraZeneca (AZ) and Pfizer.

The so-called National Lung Matrix trial will use genetic analysis of lung tumours to target therapies from the companies’ compound libraries to small groups of patients who are more likely to benefit from a particular drug.

The programme is jointly funded by CR UK, AstraZeneca and Pfizer, with support from the UK’s National Health Service (NHS). It amounts to around £25 million worth of research in total.

Led by chief investigator Professor Gary Middleton, in conjunction with the Early Drug Development Team at the Cancer Research UK Clinical Trials Unit in Birmingham, the National Lung Matrix trial will build on the first phase of CR UK’s existing Stratified Medicine Programme.

According to Professor Middleton, it will be “one of the largest ever personalised medicine trials in any cancer, one which attempts to match the right treatment to the right patient based on an in-depth understanding of what makes their own cancer cells grow and survive”.

Stratified Medicine Programme

Cancer Research UK’s £5.5 million Stratified Medicine Programme, which is supported by AstraZeneca and Pfizer, was designed to create a multi-gene testing panel and associated database so that treatment with oncology therapies could be tailored to specific tumour characteristics.

The initial phase involved testing up to 9,000 tumour samples from patients with breast, bowel, lung, prostate and ovarian cancer, as well as melanoma, to demonstrate how molecular diagnosis of NHS patients’ tumours could be scaled up to provide a national service.

Personalised treatment

“We know that every patient’s cancer is unique, so we’re now moving away from a ‘one size fits all’ approach and instead striving for more personalised treatment,” noted Dr Harpal Kumar, chief executive of Cancer Research UK.

“Critically, we are shifting the emphasis from designing a trial around a specific drug, to designing it around selecting from a range of drugs for a specific patient,” Kumar added.  

The National Lung Matrix trial will start later this year at centres across the UK. Researchers will have “unprecedented access” to libraries of drugs developed by AstraZeneca and Pfizer, allowing several compounds to be tested at the same time within a single trial, CR UK said.

Medicines that show promise in the small groups of targeted patients may be fast-tracked into larger trials involving more patients who have shown the same genetic changes in their tumours.

Moreover, new medicines can be added to the trial as experimental treatments advance through the companies’ development pipelines.

Rare mutations

As many as 14 medicines could be included over the course of the trial: up to 12 from AstraZeneca and its biologics-research arm, MedImmune, plus two from Pfizer.

These medicines “target very specific and often rare mutations, meaning they could offer hope for patients who would otherwise have very limited treatment options”, CR UK pointed out.