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Clinical Trial Matching - Quick Start Guide

Overview

This skill matches patients to optimal clinical trials based on their molecular profile, disease characteristics, and eligibility criteria. It searches ClinicalTrials.gov and cross-references molecular databases to produce evidence-graded, scored trial recommendations.

Basic Usage

Simply describe your patient profile and ask for trial matches:

Find clinical trials for a patient with non-small cell lung cancer,
EGFR L858R mutation, Stage IV, who failed first-line osimertinib.

Use Case Examples

1. Targeted Therapy Matching

Patient profile:
- Disease: Non-small cell lung cancer (adenocarcinoma)
- Biomarker: EGFR L858R mutation
- Stage: Stage IV, metastatic
- Prior treatment: Failed platinum-based chemotherapy
- ECOG: 0-1

Find the best clinical trial matches.

2. Immunotherapy Selection

Match clinical trials for:
- Melanoma, advanced/metastatic
- TMB-high (>10 mut/Mb)
- PD-L1 positive (TPS >= 50%)
- Failed ipilimumab/nivolumab combination
- ECOG 0

3. Basket Trial Identification

Find basket/tumor-agnostic trials for a patient with:
- Solid tumor (colorectal cancer)
- NTRK1 fusion detected by NGS
- No prior TRK inhibitor therapy

4. Post-Progression Options

Clinical trial options for:
- HR+/HER2- breast cancer
- Failed CDK4/6 inhibitor (palbociclib) + letrozole
- ESR1 Y537S mutation detected
- Bone and liver metastases

5. Novel Biomarker Trials

Find trials for:
- Colorectal cancer, Stage IV
- KRAS G12C mutation
- Failed FOLFOX + bevacizumab
- MSS (microsatellite stable)

6. Geographic Search

Find lung cancer clinical trials:
- Non-small cell lung cancer, any molecular subtype
- Prefer trials in Boston, Massachusetts area
- Currently recruiting
- Phase II or III only

What You Get

For each patient, the skill produces:

  1. Executive Summary - Top 3 trial recommendations with Trial Match Scores
  2. Patient Profile - Standardized disease/biomarker information with EFO and gene IDs
  3. Biomarker Actionability - FDA-approved vs investigational status
  4. Ranked Trial List - Up to 10+ trials with detailed scoring breakdown:
    • Molecular Match (0-40 points)
    • Clinical Eligibility (0-25 points)
    • Evidence Strength (0-20 points)
    • Trial Phase (0-10 points)
    • Geographic Feasibility (0-5 points)
  5. Trial Details - NCT ID, phase, status, interventions, eligibility, locations
  6. Drug-Biomarker Alignment - Whether trial drugs target the patient's biomarkers
  7. Evidence Grading - T1 (FDA-approved) through T4 (computational)
  8. Alternative Options - Basket trials, expanded access, off-label options
  9. Additional Testing - Biomarker tests that would unlock more trials
  10. Completeness Checklist - What analyses were performed

Trial Match Score Guide

Score Tier Meaning
80-100 Optimal Strongly recommend - patient's biomarker directly targeted
60-79 Good Recommend - good disease and biomarker alignment
40-59 Possible Consider - matches on some criteria, needs discussion
0-39 Exploratory Backup - general disease trials or weak match

Tips for Best Results

  1. Be specific about biomarkers - Include variant-level detail (e.g., "EGFR L858R" not just "EGFR mutation")
  2. Include prior treatments - Post-progression trials need to know what failed
  3. Specify stage - Many trials require specific disease stages
  4. Add geographic preference - If location matters, include city/state
  5. Mention performance status - ECOG score helps filter eligibility
  6. List multiple biomarkers - Complex profiles help find the best-matched trials

Data Sources

Source What It Provides
ClinicalTrials.gov Trial search, eligibility, locations, status
OpenTargets Drug-target associations, disease ontology
CIViC Clinical variant interpretations
ChEMBL Drug mechanisms and targets
FDA Approved indications, biomarker labels
DrugBank Drug targets and pharmacology
PharmGKB Pharmacogenomics data
PubMed Literature evidence
OLS/EFO Disease ontology standardization
MyGene Gene identifier resolution

Limitations

  • Trial availability changes frequently; always verify current status at ClinicalTrials.gov
  • Eligibility assessment is approximate; final determination is by trial investigators
  • Geographic distance calculations are approximate (state/city level, not exact)
  • Report is for informational/research purposes only; discuss with healthcare team
  • Some trials may have enrollment caps not reflected in public data