TARGET National

TARGET began at the Christie and the Cancer Research UK Manchester Institute, led by Matthew Krebs and Caroline Dive, as a single-centre study of whether circulating tumour DNA could support selection for phase 1 trials. The 2019 Nature Medicine report on the first 100 patients found that a 641-gene plasma panel and tissue sequencing together identified an actionable alteration in 41 patients and matched 11 of them to a phase 1 trial, and that plasma and tissue results agreed well when circulating tumour DNA was abundant.

TARGET National opened in June 2021 with Cancer Research UK funding and a target of 6,000 patients recruited through experimental cancer medicine centres across the country. Every participant has blood and, where available, tissue sequenced, results are reviewed by a national molecular tumour board and matched to open early-phase trials, and the linked clinical and genomic data build a research resource on how advanced cancers evolve under treatment. It is observational: the trials patients enter are separate studies.

The programme's contribution is logistics rather than a drug result: a common national pipeline from blood draw to trial slot, faster than the tissue-based screening of the National Lung Matrix Trial, and a cohort that DETERMINE and other United Kingdom platforms can draw on. What remains to be shown is how many screened patients actually reach a matched trial, and whether the pipeline shortens the time from progression to experimental treatment enough to change outcomes.