# NCI-COG Pediatric MATCH (APEC1621)

Source: https://onco.cc/trials/pediatric-match/  
OnCo record `pediatric-match` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Pediatric MATCH was the first nationwide precision-medicine trial for children: every child with a relapsed solid tumour could have their tumour sequenced and, if a matching drug existed, join a trial arm for it. It proved the plumbing works, even though most single drugs given alone did little.

## Summary

Histology-agnostic screening protocol run by NCI and COG at Children's Oncology Group sites from 2017. Tumours underwent targeted cancer-gene panel sequencing and limited immunohistochemistry; patients with a predefined actionable alteration were assigned to phase 2 arms (selumetinib, larotrectinib, ensartinib, vemurafenib, erdafitinib, tazemetostat, samotolisib, ulixertinib, palbociclib, olaparib, tipifarnib, ivosidenib, selpercatinib, among others). In the first 1,000 tumours screened, testing was completed for 94.7%, actionable alterations were found in 31.5%, and 28.4% of patients were assigned and 13.1% enrolled on a treatment arm (Parsons et al., JCO 2022). MAPK-pathway alterations were most frequent (11.2%). Most single-agent arms produced few objective responses; the selumetinib arm in MAPK-altered tumours had no responses in 20 treated patients (Eckstein et al., JCO 2022), while larotrectinib in NTRK-fusion tumours and selpercatinib in RET-altered tumours were active. Screening is closed and arms are completing follow-up. Lessons: molecular screening at relapse is feasible nationally; single-agent targeted therapy is rarely enough outside fusion drivers; combination arms and earlier-line testing are the next step.

## Fields

- Kind: Trial
- Status: active
- Last checked: 2026-09-10
- Tags: nci-coverage; paediatric; precision-medicine
- Registry id: NCT03155620
- Phase: platform
- Setting: Relapsed or refractory solid tumours, non-Hodgkin lymphomas and histiocytic disorders, age 1-21: tumour sequencing then assignment to one of a dozen single-agent targeted-therapy phase 2 arms
- Sponsor: National Cancer Institute / Children's Oncology Group
- Enrolled: 1377
- Result: Actionable alteration in 31.5% of the first 1,000 tumours; 28.4% assigned and 13.1% enrolled on a treatment arm.
- Outcomes: Actionable alteration detected (first 1,000 tumours): Screened tumours 31.5%; Enrolled on a treatment arm: Screened patients 13.1%
- Replication: European counterparts (ESMART, run by ITCC, and the INFORM registry in Germany) reached similar conclusions about feasibility and about the weakness of single-agent targeting outside fusion drivers.

## Sources

- ClinicalTrials.gov NCT03155620: https://clinicaltrials.gov/study/NCT03155620
- Parsons et al., JCO 2022 (screening results): https://doi.org/10.1200/JCO.21.02838
- Eckstein et al., JCO 2022 (selumetinib arm): https://doi.org/10.1200/JCO.21.02840
- NCI: Pediatric MATCH: https://www.cancer.gov/about-cancer/treatment/clinical-trials/nci-supported/pediatric-match

## Connected records

- technologies: [Clinical NGS bioinformatics and variant interpretation](https://onco.cc/technologies/ngs-bioinformatics-software/), [Comprehensive genomic profiling](https://onco.cc/technologies/cgp/)
- drugs: [Erdafitinib](https://onco.cc/drugs/erdafitinib/), [Ivosidenib](https://onco.cc/drugs/ivosidenib/), [Larotrectinib](https://onco.cc/drugs/larotrectinib/), [Olaparib](https://onco.cc/drugs/olaparib/), [Palbociclib](https://onco.cc/drugs/palbociclib/), [Selpercatinib](https://onco.cc/drugs/selpercatinib/), [Tazemetostat](https://onco.cc/drugs/tazemetostat/), [Vemurafenib](https://onco.cc/drugs/vemurafenib/)
- companies: [Children's Oncology Group (COG)](https://onco.cc/companies/childrens-oncology-group/), [Innovative Therapies for Children with Cancer (ITCC)](https://onco.cc/companies/itcc/)
- institutions: [National Cancer Institute (NIH)](https://onco.cc/institutions/nci/)
- terms: [Accrual and enrolment](https://onco.cc/terms/accrual/), [Basket trial](https://onco.cc/terms/basket-trial/), [Basket, umbrella, and platform trials](https://onco.cc/terms/basket-umbrella-platform/), [Master protocol (platform, basket and umbrella trials)](https://onco.cc/terms/master-protocol/), [RACE for Children Act](https://onco.cc/terms/race-for-children-act/), [Seamless, adaptive and Bayesian trial designs](https://onco.cc/terms/seamless-adaptive/), [Umbrella trial](https://onco.cc/terms/umbrella-trial/)
- bottlenecks: [Rare and paediatric cancers without markets](https://onco.cc/bottlenecks/b-rare-cancers/), [Trial design, endpoints and cost](https://onco.cc/bottlenecks/b-trial-design/)
- key papers: [Actionable Tumor Alterations and Treatment Protocol Enrollment of Pediatric and Young Adult Patients With Refractory Cancers in the National Cancer Institute-Children's Oncology Group Pediatric MATCH Trial](https://onco.cc/key-papers/paper-parsons-j-clin-oncol/), [Phase II Study of Selumetinib in Children and Young Adults With Tumors Harboring Activating Mitogen-Activated Protein Kinase Pathway Genetic Alterations: Arm E of the NCI-COG Pediatric MATCH Trial](https://onco.cc/key-papers/paper-eckstein-j-clin-oncol/)
- ideas: [Group trials by broken mechanism, not by organ or single mutation](https://onco.cc/ideas/idea-bio2-mechanism-defined-baskets/)
- cancers: [Atypical teratoid/rhabdoid tumour (ATRT)](https://onco.cc/cancers/atrt/), [Diffuse midline glioma, H3 K27-altered (including DIPG)](https://onco.cc/cancers/dipg-dmg/), [Ependymoma](https://onco.cc/cancers/ependymoma/), [Paediatric low-grade glioma](https://onco.cc/cancers/paediatric-low-grade-glioma/), [Rare cancers of childhood (NCI PDQ umbrella)](https://onco.cc/cancers/rare-childhood-cancers/)
- roadmaps: [Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first](https://onco.cc/roadmaps/paediatric-oncology-roadmap/), [Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on](https://onco.cc/roadmaps/trial-modernisation-roadmap/)
- trials: [NCI-MATCH (EAY131)](https://onco.cc/trials/nci-match/)

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