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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.
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.
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.
1,377 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Actionable alteration detected (first 1,000 tumours)primary | Screened tumours | 1,000 | 31.5% | - | - | link |
| Enrolled on a treatment arm | Screened patients | 1,000 | 13.1% | - | - | link |
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.
Shares Innovative Therapies for Children with Cancer (ITCC), RACE for Children Act, Diffuse midline glioma, H3 K27-altered (including DIPG), Paediatric low-grade glioma and the tag paediatric.
Shares Rare cancers of childhood (NCI PDQ umbrella), Children's Oncology Group (COG) and the tag paediatric.
Shares Atypical teratoid/rhabdoid tumour (ATRT), Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first, Children's Oncology Group (COG) and the tag paediatric.
Shares Innovative Therapies for Children with Cancer (ITCC), RACE for Children Act, Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first, Children's Oncology Group (COG) and the tag paediatric.
Shares Rare and paediatric cancers without markets and the tag paediatric.
Shares RACE for Children Act, Diffuse midline glioma, H3 K27-altered (including DIPG), Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first, Rare and paediatric cancers without markets and the tag paediatric.
Shares RACE for Children Act, Paediatric low-grade glioma, Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first and the tag paediatric.
Shares RACE for Children Act, Paediatric low-grade glioma, Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first and the tag paediatric.