myeloMATCH Hits Its Stride

The National Cancer Institute’s myeloMATCH trial has been open for 18 months now, and I want to give a brief update on its status and successes to date.

Formally “Myeloid Malignancies Molecular Analysis for Therapy Choice,” myeloMATCH is one of the NCI’s second generation of precision medicine trials (along with ComboMATCH and ImmunoMATCH, or iMATCH). 

Under the trial’s core screening protocol, blood and bone marrow samples from patients newly diagnosed with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) are analyzed to assign each patient to an appropriate treatment sub-study based on the clinical, cytogenetic, and molecular features of their disease. One of its major goals is giving our patients the ability to serially enroll to different sub-studies, as the need arises (see below). 

myeloMATCH is a pan-NCTN endeavor, with a core team from NCI’s Cancer Therapy Evaluation Program collaborating closely with the leukemia committees of the Alliance, ECOG-ACRIN, the Canadian Cancer Trials Group (CCTG), and SWOG. SWOG is leading the study’s screening protocol (MYELOMATCH).

(And please note that SWOG is also coordinating the screening protocol for the iMATCH precision medicine trial, elements of which are now being piloted in our S2101 BiCaZO trial.)

myeloMATCH opened in May of 2024, and enrollment to the screening protocol has been robust. So much so, in fact, that earlier this year a slot reservation system was implemented as the first step in patient enrollment. A fixed number of enrollment slots are made available each day, to ensure the number of submissions for biomarker profiling does not exceed the capacity of the system and slow turnaround times for results and sub-study assignments.

The screening protocol has been opened at more than 300 sites throughout the U.S. and Canada, and more than 800 patients have been enrolled. Earlier this week, at the American Society for Hematology (ASH) 2025 annual meeting, a poster reported on the first 550 patients consented to the MYELOMATCH protocol. 

Another key objective of this protocol is to demonstrate that the process and infrastructure can reliably and consistently post accurate assay results for sub-study assignment review within 72 hours of specimen receipt, ensuring patients newly diagnosed with AML or MDS can start their sub-study treatment within a few days.

Median turnaround times reported at ASH for the trial’s first 14 months were 69 hours for cytogenetics results and 49 hours for next-generation sequencing (NGS) results, with 91 percent of cytogenetics results and 95 percent of NGS results returned within the target window of 72 hours or less.

These numbers are good news, documenting that MYELOMATCH can achieve its desired turnaround times for the vast majority of patients. 

The component that truly makes myeloMATCH unique is its ability to follow patients through the entire course of their disease journey, allowing them to enroll sequentially to treatment trials based on treatment stage. 

If there’s no appropriate treatment sub-study available for a given patient, they are assigned to the trial’s Tier Advancement Pathway (TAP), a protocol that allows us to continue to follow them as they undergo standard-of-care therapy and that keeps open the potential for that patient to enroll to another myeloMATCH sub-study in a later tier, when they’ve completed initial treatment. 

At the end of the 14-month period reported at ASH, about 44 percent of patients undergoing initial screening were being assigned to a treatment sub-study rather than to TAP, an assignment rate that was increasing rapidly at the 14-month mark and that is expected to climb even more quickly as more sub-studies are opened. 

As the count of screened patients grows, data from assay results are being analyzed to generate valuable insights. Several ASH abstracts reported analyses done to identify optimal parameters for rapid turnaround of high quality results, to track rates of individual mutations and associations among co-mutations, and to generally advance our understanding of how these biomarkers can be used in the diagnosis and prognosis of myeloid cancers. 

The NCI’s website posted a brief story earlier this week about myeloMATCH at ASH 2025, with a full list of abstracts reporting on the trial.

At present, five treatment sub-studies are open within the myeloMATCH framework. Four of these are in AML – two led by SWOG and one each by ECOG-ACRIN and CCTG – and one is in MDS, led by the Alliance.  

Roughly a dozen other sub-study protocols are now in development, including SWOG’s MM1OA-S04, which is expected to activate in February.

As myeloMATCH closes out 2025, its first full calendar year of operation, it’s well on its way to its goal of expanding personalized treatment opportunities for patients all across the U.S. and Canada who have been diagnosed with AML or MDS. It’s a hugely important research project for individual patients and as a model for modern-day clinico-translational research. SWOG is proud to be part of it.