Huntsman Cancer Institute at the University of Utah (the U) has joined other institutions in an innovative clinical trials program designed to match patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) with a clinical trial specifically designed for the genetic signature of their disease. Sponsored by the National Cancer Institute (NCI), the myeloMATCH program aims to improve precision medicine, the use of therapies based on the unique makeup of an individual's cancer. This program is potentially a pivotal advance in personalized cancer care.
Paul Shami, MD, investigator at Huntsman Cancer Institute and professor of medicine in the Division of Hematology and Hematologic Malignancies at the U, is one of the principal investigators involved in the myeloMATCH program.
For a long time, we had just one aggressive chemotherapy treatment program for AML. In the past few years, we have evolved from the one size fits all model to where we have many treatment options. To be able to put those options within a rational, scientifically designed clinical trials program is exciting and will hopefully move the field forward."
Paul Shami, MD, investigator at Huntsman Cancer Institute
Patients in the myeloMATCH program start by undergoing a bone marrow biopsy for diagnosis and screening. Depending on the genetic signature of their disease, they are assigned different trials specifically designed for their disease type. Throughout their journey in myeloMATCH, patients are assigned to different tiers of treatment depending on their response to therapy.
One important aspect of myeloMATCH is the use of groundbreaking technology to detect very low levels of disease-;known as measurable residual disease (MRD).
"Not too long ago, a patient would be in remission, and a bone marrow biopsy would look clear under the microscope. But if we use these very sensitive tools to look for very, very low levels of disease, results can be different. Even that low level of residual disease has a negative prognostic impact," says Shami. "But this type of molecular evaluation is not available everywhere, and myeloMATCH provides a systematic strategy to use MRD for treatment assignment."
AML is a rare type of blood cancer, affecting about 20,000 patients per year in the U.S. MDS is a disease that leads to failure of the bone marrow and a drop in the number of blood cells. MDS can sometimes progress to AML. According to the National Cancer Institute, the five-year survival rate of AML among adults is just 31%. The average age of diagnosis is 69 years old.
"The myeloMATCH program gives us more treatment options to offer patients, including older or frail patients who would not be good candidates for aggressive chemotherapy, let alone a bone marrow transplant," says Shami.
The initiative is designed to harness the scientific resources of the NCI's National Clinical Trials Network, which supports clinical trials at over 2,000 sites nationally. The network is made up of several cooperative groups.
The myeloMATCH program combines the resources of the Alliance for Clinical Trials in Oncology, ECOG-ACRIN, and SWOG. The Canadian Cancer Trials Group is also participating.
The NCI funds myeloMATCH, as well as the other precision medicine initiatives. The Huntsman Cancer Institute research described in this release is supported by the National Institutes of Health/NCI including P30 CA042014, and Huntsman Cancer Foundation.
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