Network-Integrated Platform for Clinical Trial Navigation from the New South Wales Early Phase Clinical Trials Alliance

作者：Jia Liu, Max Farrow, Sandra S. Hsing, Rasha Cosman, Charlotte Lemech, Christina T. Teng, Abhijit Pal, Udit Nindra, Andrew Parsonson, John Park, Anthony Rodrigues, Wei Yen Chan, Joe Wei, Jordan E. Cohen, Craig Underhill, Daniel Brungs, Mun N. Hui, Adnan Nagrial, Suyog Jain, Anthony M. Joshua · 发表于：Clinical Cancer Research · 年份：2026 · DOI：10.1158/1078-0432.ccr-26-0733 · 研究领域：Cancer Genomics and Diagnostics、Ethics in Clinical Research、Statistical Methods in Clinical Trials

PURPOSE: Access to early-phase clinical trials (EPCTs) is increasingly constrained by delays in genomic testing and lack of coordinated system-level navigation. The New South Wales Early Phase Clinical Trials Alliance (NECTA) was established to improve EPCT access. PANNA-COTA (Practical Assessment of NECTA Network Assistance in Cancer Outpatient Trials Access) prospectively evaluated whether integrating circulating tumour DNA (ctDNA) profiling with a real-time, cross-site molecular tumor board (MTB) facilitates EPCT enrolment. METHODS: In this multicentre prospective study across nine NECTA sites, patients referred for EPCT consideration underwent ctDNA testing using the Guardant360® 74-gene assay. Results were reviewed at a fortnightly MTB incorporating cross-site trial mapping and dynamic eligibility review. The primary endpoint was proportion enrolled into EPCTs. Secondary endpoints included ctDNA findings and trial outcomes. RESULTS: Of 104 consented participants, 101 were eligible. Participants had advanced, heavily pre-treated solid tumours; 48% lacked prior tumour NGS. ctDNA alterations were detected in 85%, with actionable alterations in 44%. Therapeutic options were identified in 88%, and EPCTs were recommended in 76%. Despite this, only 7% of participants received genomically matched therapy. In contrast, 37% enrolled in EPCTs within 3 months and 47% overall (95% CI 0.37-0.56). Among enrolled participants, disease control rate was 81% and objective response rate 33%...