British researchers, working with two global pharmaceutical companies, are planning to launch a different kind of personalized medicine clinical trial that could change how cancer drugs are studied and potentially cut the time and cost of bringing them to market.
Instead of the traditional method of testing one drug at a time, British researchers at Cancer Research U.K. have teamed up with AstraZeneca and Pfizer to test up to 14 drugs to treat patients with advanced stages of lung cancer, using genetic tests to identify changes in their tumors. Once the genetics of each tumor are identified, patients will be given a specific drug that targets specific and often rare mutations. Researchers then will look for signs of improvement, including increased survival, tumor shrinkage or an alleviation of symptoms.
“We are shifting the emphasis from designing a trial around a specific drug to designing it around selecting from a range of drugs for specific patients,” said Harpal Kumar, chief executive of Cancer Research U.K., considered the world’s largest independent and publicly-funded cancer research organization focused on prevention, diagnosis and treatment, at a press conference in London this week. “The challenge has been developing treatments that show a long-term benefit for patients while accommodating the cost of widespread molecular testing in the National Health Service. This partnership is exciting because we’re trying to achieve something that none of us could manage alone.”
The most promising medicines in the small group of patients may be fast-tracked into larger trials with more patients who have the same genetic changes. The initial trial is expected to start this summer by the NHS and the network of 18 Cancer Research U.K. centers. NHS hospitals will test tumor samples and use the information to help match cancer patients to the most appropriate drug treatment.
“This is one of the largest ever personalized medicine trials in any cancer, one which attempts to match the right treatment to the right patient based on an in-depth understanding of what makes their own cancer cells grow and survive,” said Cancer Research U.K.’s chief investigator professor Gary Middleton.
Of the 14 medicines tested, 12 are from AstraZeneca and its biologics research subsidiary MedImmune, and two are from Pfizer. The $42 million project, called the National Lung Matrix trial, is funded by Cancer Research U.K. and the two sponsors, with support from the National Health Service.
An estimated 42,000 people are diagnosed with lung cancer in the U.K. every year, and the disease kills 35,000 people annually, with only 9% of patients surviving beyond five years after diagnosis, according to Cancer Research U.K.
For AstraZeneca, the targeted therapies, which address the underlying mechanisms of disease, are the future of personalized healthcare.
“It’s an approach that will allow us to push the boundaries of science, not only to bring the right treatment to the right patients, but also to uncover new treatments for those who currently have limited options,” said Menelas Pangalos, executive vice president, Innovative Medicines and Early Development, in a statement. “Ultimately this innovative collaboration will help establish the framework for how patients will be treated in the NHS in the future, giving them a considerably higher chance of receiving an effective drug to tackle their cancer.”
The ambitious National Lung Matrix trial is part of a growing cancer research trend to remodel how new drugs are tested, with a goal of personalizing the treatments to the genetic profile of patients. In the U.S., Friends of Cancer Research, a think tank and advocacy organization that develops partnerships with both the public and private sectors to conquer cancer, announced in November its backing of a similar, albeit smaller, multi-drug clinical trial evaluation testing five experimental drug compounds in patients with lung cancer.