Department of Breast and Medical Oncology, Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan.
Department of Breast and Medical Oncology, Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan.
Clin Pharmacol Ther. 2020 Sep;108(3):596-605. doi: 10.1002/cpt.1817. Epub 2020 Apr 7.
For rare cancers, challenges in establishing standard therapies are greater than those for major cancers, and effective methods are needed. MASTER KEY Project is a multicenter study based in Japan, with two main parts: prospective registry study and multiple clinical trials. Advanced rare cancers, cancers of unknown primary origin, and those with rare tissue subtypes of common cancers are targeted. The registry study accumulates highly reliable consecutive data that can be used for future drug development. The multiple trials are conducted simultaneously, targeting either a specific biomarker or a rare tumor type of interest. The first interim data set from the registry part presented here shows the prevalence of genetic abnormalities, response rates, survival rates, and clinical trial enrollment rates. From May 2017 to April 2019, 560 patients (mean age = 53) were enrolled in the project. Frequent cancer types included soft tissue sarcomas, neuroendocrine tumors, and central nervous system tumors. Among the 528 patients with assessable data, 69% (364/528) had next-generation sequencing tests, with 48% (176/364) harboring an "actionable" alteration. Seventy-one (13%) patients have been enrolled in one of the clinical trials, with an accrual rate of 3.94 patients/month. A descriptive analysis of biomarker-directed or non-biomarker-directed treatment survival was performed. This project is expected to accelerate development of treatments for rare cancers and show that comprehensive platform trials are an advantageous strategy.
对于罕见癌症,建立标准治疗方法的挑战大于主要癌症,因此需要有效的方法。MASTER KEY 项目是一项在日本进行的多中心研究,包括两个主要部分:前瞻性登记研究和多个临床试验。该研究以晚期罕见癌症、原发灶不明癌症和常见癌症中罕见组织亚型的癌症为目标。登记研究积累了高度可靠的连续数据,可用于未来的药物开发。同时进行多个试验,针对特定的生物标志物或感兴趣的罕见肿瘤类型。这里展示的登记部分的第一个中期数据集显示了遗传异常、缓解率、生存率和临床试验入组率的流行情况。从 2017 年 5 月至 2019 年 4 月,该项目共招募了 560 名患者(平均年龄 53 岁)。常见的癌症类型包括软组织肉瘤、神经内分泌肿瘤和中枢神经系统肿瘤。在可评估数据的 528 名患者中,有 69%(364/528)进行了下一代测序检测,其中 48%(176/364)存在“可操作”改变。71 名(13%)患者已参加其中一项临床试验,每月入组患者 3.94 名。对基于生物标志物或非生物标志物的治疗生存进行了描述性分析。该项目有望加速罕见癌症治疗方法的开发,并表明综合平台试验是一种有利的策略。