Strategic SWOG Studies Stay Strong

Here’s the scoop:

• DART, Dual Anti-CTLA-4 & Anti-PD-1 blockade in Rare Tumors, is our immunotherapy trial devoted to uncommon cancers. DART gives patients with a variety of rare tumor types access to the latest drugs – in this case the immunotherapy combination of ipilimumab and nivolumab. DART has enrolled 739 patients to date, with a total goal of 818. That means trial accrual is at 90 percent! DART has open 15 sub-studies. Another 38 have already been closed, with some results reported out at ASCO and AACR virtual meetings this year.
   
• Lung-MAP is our flagship precision medicine trial, conducted in partnership with the NCI, the Foundation for the National Institutes of Health, and Friends of Cancer Research. After a January 2019 major expansion to serve all non-small cell lung cancer patients, the trial is going gangbusters. Lung-MAP accrual has proceeded at a strong clip, even during the pandemic, and the trial has three sub-studies open. One sub-study is testing a buzz-worthy agent from Loxo Oncology – selpercatinib or LOXO-292 – in patients with previously-treated stage IV or recurrent RET fusion-positive non-small cell lung cancer. We’re all eagerly awaiting results on that one.
   
• ImmunoMATCH, or iMATCH, is one of the next generation NCI precision medicine trials and it’s being managed right here at SWOG. The leadership breakdown: Our immunotherapy committee oversees the master protocol; Drs. Kenneth Grossmann and Katerina Politi supervise the screening protocol; and Dr. Siwen Hu-Lieskovan guides SWOG’s sub-study portfolio. In iMATCH, tumors will be categorized into different groups representing biological mechanisms of resistance – prospective biomarker stratification that can facilitate precision medicine. Once enrolled, patients will get immune profile testing and be assigned to a sub-study based on their tumor mutation burden and gamma interferon signature. iMATCH isn’t expected to launch until 2022. However, in June, the SWOG executive review team approved the concept for the iMATCH pilot study, to be run by Drs. Hu-Lieskovan, Politi, and Paul Swiecicki. That pilot will likely activate in 2021, and even has a trial number: S2101. Look for it!
   
• ComboMATCH is an iteration of MATCH, the precision trial run by ECOG-ACRIN. ECOG is also leading ComboMATCH, which will test combinations of targeted agents to see if they deliver higher response rates. When it activates in 2021, ComboMATCH will include drug pairings that are supported with some preclinical or early clinical data, and be based on a genomic selection marker as is consistent with other precision medicine trials. SWOG Executive Officer Dr. Gary Lyman is overseeing all the SWOG sub-studies assigned to ComboMATCH – and we already have two phase I studies approved by the ETCTN and another phase II in the works. Even though it’s still in the planning stages, ComboMATCH is already robust. We’ve got our three sub-studies in the mix (and may soon have a fourth), NRG Oncology has proposed four, the Alliance has proposed three, and ECOG-ACRIN has proposed one.

It’s amazing how much progress is being made on these trials, even with a pandemic raging. For example, the iMATCH team is holding monthly calls and hasn’t skipped a beat. These trial teams are an inspiration and, in these uncertain times, a comfort. Science may have slowed a bit, but progress never stops.