{"entity":{"id":"pediatric-match","kind":"trial","name":"NCI-COG Pediatric MATCH (APEC1621)","aka":[],"tldr":"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.","status":"active","asOf":"2026-09-10","links":[{"label":"ClinicalTrials.gov NCT03155620","url":"https://clinicaltrials.gov/study/NCT03155620"},{"label":"Parsons et al., JCO 2022 (screening results)","url":"https://doi.org/10.1200/JCO.21.02838"},{"label":"Eckstein et al., JCO 2022 (selumetinib arm)","url":"https://doi.org/10.1200/JCO.21.02840"},{"label":"NCI: Pediatric MATCH","url":"https://www.cancer.gov/about-cancer/treatment/clinical-trials/nci-supported/pediatric-match"}],"tags":["nci-coverage","paediatric","precision-medicine"],"related":[],"cancers":[],"sections":[],"technologies":["cgp","ngs-bioinformatics-software"],"targets":[],"drugs":["larotrectinib","selpercatinib","vemurafenib","erdafitinib","tazemetostat","palbociclib","olaparib","ivosidenib"],"companies":["childrens-oncology-group","itcc"],"institutions":["nci"],"pathways":[],"terms":["basket-umbrella-platform","race-for-children-act"],"trials":[],"people":[],"bottlenecks":["b-rare-cancers","b-trial-design"],"keyPapers":["paper-parsons-j-clin-oncol","paper-eckstein-j-clin-oncol"],"journals":[],"dependsOn":[],"notes":[],"nct":"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","result":"Actionable alteration in 31.5% of the first 1,000 tumours; 28.4% assigned and 13.1% enrolled on a treatment arm.","started":"2017-07-31","startedType":"actual","yearReported":2022,"enrolled":1377,"enrolledBasis":"registry","outcomes":[{"endpoint":"Actionable alteration detected (first 1,000 tumours)","primary":true,"unit":"%","arms":[{"name":"Screened tumours","n":1000,"value":31.5}],"source":"https://doi.org/10.1200/JCO.21.02838"},{"endpoint":"Enrolled on a treatment arm","unit":"%","arms":[{"name":"Screened patients","n":1000,"value":13.1}],"source":"https://doi.org/10.1200/JCO.21.02838"}],"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."},"route":"/trials/pediatric-match/","neighbours":{"technology":[{"id":"ngs-bioinformatics-software","kind":"technology","name":"Clinical NGS bioinformatics and variant interpretation","route":"/technologies/ngs-bioinformatics-software/"},{"id":"cgp","kind":"technology","name":"Comprehensive genomic profiling","route":"/technologies/cgp/"}],"drug":[{"id":"erdafitinib","kind":"drug","name":"Erdafitinib","route":"/drugs/erdafitinib/"},{"id":"ivosidenib","kind":"drug","name":"Ivosidenib","route":"/drugs/ivosidenib/"},{"id":"larotrectinib","kind":"drug","name":"Larotrectinib","route":"/drugs/larotrectinib/"},{"id":"olaparib","kind":"drug","name":"Olaparib","route":"/drugs/olaparib/"},{"id":"palbociclib","kind":"drug","name":"Palbociclib","route":"/drugs/palbociclib/"},{"id":"selpercatinib","kind":"drug","name":"Selpercatinib","route":"/drugs/selpercatinib/"},{"id":"tazemetostat","kind":"drug","name":"Tazemetostat","route":"/drugs/tazemetostat/"},{"id":"vemurafenib","kind":"drug","name":"Vemurafenib","route":"/drugs/vemurafenib/"}],"company":[{"id":"childrens-oncology-group","kind":"company","name":"Children's Oncology Group (COG)","route":"/companies/childrens-oncology-group/"},{"id":"itcc","kind":"company","name":"Innovative Therapies for Children with Cancer (ITCC)","route":"/companies/itcc/"}],"institution":[{"id":"nci","kind":"institution","name":"National Cancer Institute (NIH)","route":"/institutions/nci/"}],"term":[{"id":"accrual","kind":"term","name":"Accrual and enrolment","route":"/terms/accrual/"},{"id":"basket-trial","kind":"term","name":"Basket trial","route":"/terms/basket-trial/"},{"id":"basket-umbrella-platform","kind":"term","name":"Basket, umbrella, and platform trials","route":"/terms/basket-umbrella-platform/"},{"id":"master-protocol","kind":"term","name":"Master protocol (platform, basket and umbrella trials)","route":"/terms/master-protocol/"},{"id":"race-for-children-act","kind":"term","name":"RACE for Children Act","route":"/terms/race-for-children-act/"},{"id":"seamless-adaptive","kind":"term","name":"Seamless, adaptive and Bayesian trial designs","route":"/terms/seamless-adaptive/"},{"id":"umbrella-trial","kind":"term","name":"Umbrella trial","route":"/terms/umbrella-trial/"}],"bottleneck":[{"id":"b-rare-cancers","kind":"bottleneck","name":"Rare and paediatric cancers without markets","route":"/bottlenecks/b-rare-cancers/"},{"id":"b-trial-design","kind":"bottleneck","name":"Trial design, endpoints and cost","route":"/bottlenecks/b-trial-design/"}],"paper":[{"id":"paper-parsons-j-clin-oncol","kind":"paper","name":"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","route":"/key-papers/paper-parsons-j-clin-oncol/"},{"id":"paper-eckstein-j-clin-oncol","kind":"paper","name":"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","route":"/key-papers/paper-eckstein-j-clin-oncol/"}],"idea":[{"id":"idea-bio2-mechanism-defined-baskets","kind":"idea","name":"Group trials by broken mechanism, not by organ or single mutation","route":"/ideas/idea-bio2-mechanism-defined-baskets/"}],"cancer":[{"id":"atrt","kind":"cancer","name":"Atypical teratoid/rhabdoid tumour (ATRT)","route":"/cancers/atrt/"},{"id":"dipg-dmg","kind":"cancer","name":"Diffuse midline glioma, H3 K27-altered (including DIPG)","route":"/cancers/dipg-dmg/"},{"id":"ependymoma","kind":"cancer","name":"Ependymoma","route":"/cancers/ependymoma/"},{"id":"paediatric-low-grade-glioma","kind":"cancer","name":"Paediatric low-grade glioma","route":"/cancers/paediatric-low-grade-glioma/"},{"id":"rare-childhood-cancers","kind":"cancer","name":"Rare cancers of childhood (NCI PDQ umbrella)","route":"/cancers/rare-childhood-cancers/"}],"roadmap":[{"id":"paediatric-oncology-roadmap","kind":"roadmap","name":"Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first","route":"/roadmaps/paediatric-oncology-roadmap/"},{"id":"trial-modernisation-roadmap","kind":"roadmap","name":"Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on","route":"/roadmaps/trial-modernisation-roadmap/"}],"trial":[{"id":"nci-match","kind":"trial","name":"NCI-MATCH (EAY131)","route":"/trials/nci-match/"}]}}