Review Article

Biomarker-Driven Oncology Clinical Trials: Novel Designs in the Era of Precision Medicine

Donald C. Moore,(1) PharmD, BCPS, BCOP, DPLA, FCCP, and Andrew S. Guinigundo,(2) MSN, RN, CNP, ANP-BC

From (1)Department of Pharmacy, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina; (2)Cincinnati Cancer Advisors, Cincinnati, Ohio

Correspondence to: Donald C. Moore, PharmD, BCPS, BCOP, DPLA, FCCP, Levine Cancer Institute, 1021 Morehead Medical Drive, Charlotte, NC 28204. E-mail: donald.moore1@atriumhealth.org


J Adv Pract Oncol 2023;14(Suppl 1):9–13 | https://doi.org/10.6004/jadpro.2023.14.3.16 | © 2023 Harborside™


  

ABSTRACT

Oncology drug development historically has followed a path of sequential phase I, II, and III clinical trials using traditional trial designs, with the goal of achieving regulatory approval. These studies are often conducted with inclusion criteria that limit enrollment to a single tumor type or tumor site of origin, excluding other patients who might also respond. Increased use of precision medicine targeting biomarkers or specific oncogenic mutations has led to novel clinical trial designs that can evaluate these therapies in a less limited fashion. Master protocols such as basket trials, umbrella trials, and platform trials can, for example, evaluate histology-specific therapies targeting a common oncogenic mutation across multiple tumor types or screen for the presence of multiple different biomarkers rather than a single one. In other cases, they can lead to more rapid evaluation of a drug and evaluate targeted therapies in tumor types for which they are not yet currently indicated. As the use of complex biomarker-based master protocols increases, advanced practitioners must understand these novel trial designs, their advantages and disadvantages, and how their use may advance drug development and maximize the clinical benefits of molecular precision therapy. 

Advances in Biomarker-Driven Therapy: Implications for Advanced Practitioners
Revolutionizing Cancer Treatment: Harnessing the Power of Biomarkers to Improve Patient Outcomes
Biomarker-Driven Oncology Clinical Trials: Novel Designs in the Era of Precision Medicine
The Role of Biomarkers in Guiding Clinical Decision-Making in Oncology
The Advanced Practitioner’s Role in the Rapidly Evolving Landscape of Precision Medicine




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