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Lung-MAP is the United States public-private umbrella trial in lung cancer: every patient gets one genomic test and is sent to whichever experimental drug matches their tumour, with the rest joining immunotherapy arms. Its first matched drugs disappointed; its immunotherapy combinations produced the platform's first survival signal.
Lung-MAP opened in June 2014 as SWOG S1400, the first master protocol run jointly by the National Cancer Institute's cooperative groups, the FDA, Friends of Cancer Research, the Foundation for the NIH and several drug companies. Patients with previously treated stage 4 squamous non-small-cell lung cancer had their tumour sequenced once with Foundation Medicine's panel; those with a matching alteration were assigned to a targeted sub-study and everyone else to a non-match sub-study, each sub-study a phase 2 that could expand seamlessly into phase 3. Roy Herbst and Vassiliki Papadimitrakopoulou led it, with Mary Redman as statistician. In 2019 it became S1900 (NCT03851445), open to all non-small-cell histologies and to patients who had already had immunotherapy.
The first generation of sub-studies is summarised in the Lancet Oncology in 2020: 1,864 patients were screened and the genotype-matched arms, taselisib for PIK3CA (S1400B), palbociclib for cell-cycle gene amplification (S1400C) and AZD4547 for FGFR alterations (S1400D), all closed for futility with few responses, while durvalumab (S1400A) and durvalumab with tremelimumab after progression on anti-PD-1 therapy (S1400F) gave modest activity. A MET-directed arm of rilotumumab with erlotinib closed early, talazoparib for homologous recombination repair alterations (S1400G) did not meet its bar, and telisotuzumab vedotin for c-MET-positive tumours (S1400K) reported a low response rate. S1400I, the platform's first phase 3, found that adding ipilimumab to nivolumab did not improve survival. The one clearly positive sub-study so far is S1800A, in which ramucirumab plus pembrolizumab improved overall survival against standard of care in patients whose cancer had progressed on both chemotherapy and immunotherapy; the pragmatic phase 3 Pragmatica-Lung (S2302) was opened to confirm it.
What Lung-MAP changed was less any one drug than the machinery: a single FDA-agreed screening assay, sub-studies designed to support approval, drug companies entering and leaving one protocol, and, from 2024, published genomic landscapes of squamous lung cancer from the screening data. What it also showed, alongside NCI-MATCH and the National Lung Matrix Trial, is that matching one drug to one mutation in squamous lung cancer rarely produces large responses, which is why the newer sub-studies pair targeted agents with immunotherapy or test combinations.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
One trial page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
One trial page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
This is the paper Europe PMC returns for registry id NCT02154490 with the most citations, so it is the natural first reading for anyone following the Lung-MAP trial. Read the abstract above alongside the trial page and the registry entry; the record was linked automatically and its figures have not been checked by hand.
One trial page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
Shares Erlotinib, Master protocol (platform, basket and umbrella trials), ECOG-ACRIN Cancer Research Group, Alliance for Clinical Trials in Oncology.
Shares Erlotinib, Master protocol (platform, basket and umbrella trials), Talazoparib, Palbociclib.
Shares Seamless, adaptive and Bayesian trial designs, Master protocol (platform, basket and umbrella trials), Palbociclib, Basket, umbrella, and platform trials.
Shares Master protocol (platform, basket and umbrella trials), ECOG-ACRIN Cancer Research Group, Basket, umbrella, and platform trials, Trial design, endpoints and cost.
Shares Master protocol (platform, basket and umbrella trials), SWOG Cancer Research Network, Basket, umbrella, and platform trials, Ipilimumab.
Shares Lung-MAP S1800A: ramucirumab plus pembrolizumab, Squamous cell carcinoma of the lung, Ramucirumab, Docetaxel.
Shares Foundation Medicine (Roche), Erlotinib, Master protocol (platform, basket and umbrella trials), Basket, umbrella, and platform trials.
Shares Ramucirumab, SWOG Cancer Research Network, Docetaxel, Pembrolizumab.