Paper - Review

DOI: 10.1038/s41586-020-2481-8

Abstract

The majority of targeted therapies
← for NSCLC
→ are directed → against oncogenic drivers
→ that are more prevalent
← in patient with (light exposure) → to tobacco smoke

The discovery of stratified medicine options
→ for tobacco-associated NSCLC
→ is a high priority ❗
∵ As this group → represents around 20% of (all patients ← with lung cancer)

Umbrella trials
→ seek → to streamline the investigation of (genotype-base treatment ← by screening tumors)
→ for 1⃣ multiple genomic alterations 2⃣ triaging patients
→ to one of several genotype-matched therapeutic agents

❗: the current outcomes of 19 drug-biomarker cohorts
← from the ongoing National Lung Matrix Trial
∴ the largest umbrella trial ← in NSCLC

Use → next-generation sequencing
→ to match patients → to appropriate targeted therapies
← on the basis of their tumor genotype

The Bayesian trial design
→ enables outcome data
← from open cohorts ← that are still recruiting
→ to be reported alongside data ← from closed cohorts

5.467 patient → were screened
2,007 → were molecularly eligible → for entry into the trial
302 → entered the trial → to receive genotype-matched therapy
14 → re-registered to the trial
→ for a sequential trial drug

❗: A limited number of combinations
→ demonstrate clinically relevant benefits
← remain concentrated ← in patient with (lung cancer)
← that are associated ← with (minimal exposure) → to tobacco smoke

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