美国国家癌症研究所治疗​​选择分子分析 (NCI-MATCH) 是一项多队列 2 期试验，根据肿瘤基因组测试将晚期癌症患者分配到分子靶向治疗。 NCI-MATCH A 组在患有 EGFR 突变的除肺癌以外的肿瘤患者中评估了阿法替尼（一种 EGFR 酪氨酸激酶抑制剂 (TKI)），阿法替尼是一种被批准用于晚期非小细胞肺癌的治疗。选定的可操作 EGFR 突变被提供参与 A 组。不允许先前使用 EGFR TKI 进行治疗。患者每天连续接受阿法替尼 40 mg 一次，直至疾病进展或出现不可接受的毒性。主要终点是客观缓解率（ORR）。次要终点包括无进展生存期 (PFS)、6 个月 PFS 和总生存期 (OS)。 17 名患者接受了方案治疗。肿瘤类型包括多形性胶质母细胞瘤 (GBM) (13)、胶质肉瘤 (1)、未另行指定的腺癌 (NOS) (2) 和乳腺癌腺鳞癌 (1)。 59% 的患者接受了≥2 线的既往治疗。 ORR 为 11.8%（90% CI，2.1 至 32.6），其中 1 次完全缓解持续 16.4 个月（GBM 含有罕见的外显子 18 EGFR-SEPT14 融合），1 次部分缓解持续 12.8 个月（具有经典 EGFR 突变的腺癌 NOS， p.Glu746_Ala750del)。三名患者病情稳定。 6 个月 PFS 为 15%（90% CI，0 至 30.7）；中位 OS 为 9 个月（90% CI，4.6 至 14.0）。皮疹和腹泻是最常见的毒性。阿法替尼在一组接受过大量治疗且患有晚期非肺 EGFR 突变肿瘤的患者中具有适度的活性，但该试验的主要终点并未达到。进一步评估阿法替尼治疗具有 EGFR 外显子 18 融合的 GBM 可能值得关注。

National Cancer Institute-Molecular Analysis for Therapy Choice (NCI-MATCH) was a multicohort phase 2 trial that assigned patients with advanced pretreated cancers to molecularly targeted therapies on the basis of tumor genomic testing. NCI-MATCH Arm A evaluated afatinib, an EGFR tyrosine kinase inhibitor (TKI) approved for advanced non-small cell lung cancer, in patients with tumors other than lung cancer harboring EGFR mutations.Patients with advanced pretreated cancers other than lung cancer found to have selected actionable EGFR mutations were offered participation in Arm A. Previous therapy with an EGFR TKI was not allowed. Patients received afatinib 40 mg once daily continuously until disease progression or unacceptable toxicity. The primary end point was objective response rate (ORR). Secondary end points included progression-free survival (PFS), 6-month PFS, and overall survival (OS).Seventeen patients received protocol therapy. Tumor types included glioblastoma multiforme (GBM) (13), gliosarcoma (1), adenocarcinoma not otherwise specified (NOS) (2), and adenosquamous carcinoma of the breast (1). Fifty-nine percent of patients received ≥2 lines of previous therapy. The ORR was 11.8% (90% CI, 2.1 to 32.6), with one complete response lasting 16.4 months (GBM harboring a rare exon 18 EGFR-SEPT14 fusion) and one partial response lasting 12.8 months (adenocarcinoma NOS with the classic EGFR mutation, p.Glu746_Ala750del). Three patients had stable disease. The 6-month PFS was 15% (90% CI, 0 to 30.7); the median OS was 9 months (90% CI, 4.6 to 14.0). Rash and diarrhea were the most common toxicities.Afatinib had modest activity in a cohort of patients with heavily pretreated cancer with advanced nonlung, EGFR-mutated tumors, but the trial's primary end point was not met. Further evaluation of afatinib in GBM with EGFR exon 18 fusions may be of interest.