# DRUP (Drug Rediscovery Protocol)

Source: https://onco.cc/trials/drup/  
OnCo record `drup` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The Dutch national trial that gives patients whose tumour carries a targetable change an already-approved drug outside its licence, inside a trial, so that what happens is recorded and the drugs that work can be paid for.

## Summary

DRUP is a prospective, non-randomised, adaptive phase 2 trial run nationally on behalf of the Center for Personalized Cancer Treatment and led by the Netherlands Cancer Institute (registry acronym M15DRU). It started in August 2016 and the registry lists it as recruiting, with an estimated enrolment of 1,550 and primary completion estimated for September 2027. Patients with advanced cancer who have exhausted standard treatment and whose tumour test shows a potentially actionable variant are matched by a molecular tumour board to one of the commercially available targeted drugs or immunotherapies that collaborating companies contribute, and treated in cohorts defined by drug, tumour type and variant; a fresh biopsy is taken before treatment for whole-genome sequencing. The registry lists Amgen, AstraZeneca, Bayer, Bristol-Myers Squibb, Novartis, Roche, Merck Sharp & Dohme, Boehringer Ingelheim, Ipsen, Eisai, Pfizer, Clovis, Eli Lilly, Janssen, GlaxoSmithKline, Incyte, the Dutch Cancer Society and Stelvio for Life as collaborators.

The first report, in Nature in 2019, found clinical benefit (response, or stable disease beyond 16 weeks) in 34 per cent of 215 treated patients and a 63 per cent benefit rate in a cohort with microsatellite-unstable tumours given nivolumab.

## Fields

- Kind: Trial
- Status: recruiting
- Last checked: 2026-11-03
- Also known as: Drug Rediscovery Protocol; DRUP trial; NCT02925234; M15DRU
- Registry id: NCT02925234
- Phase: 2
- Setting: Advanced solid tumours, multiple myeloma or B-cell non-Hodgkin lymphoma with no standard options left and a potentially actionable molecular variant; patients are matched to an approved targeted drug or immunotherapy used outside its licence
- Sponsor: Netherlands Cancer Institute
- Enrolled: 1550
- Result: First report (Nature 2019): clinical benefit in 34% of 215 treated patients; 63% in a cohort of microsatellite-unstable tumours given nivolumab.

## Sources

- ClinicalTrials.gov NCT02925234: https://clinicaltrials.gov/study/NCT02925234
- Nature 2019 first report: https://doi.org/10.1038/s41586-019-1600-x

## Connected records

- ideas: [A DRUP-style protocol for off-label generic targeted drugs in rare tumours](https://onco.cc/ideas/idea-reg-generic-targeted-therapy-drup/)
- companies: [Hartwig Medical Foundation](https://onco.cc/companies/hartwig-medical-foundation/)
- institutions: [Netherlands Cancer Institute (NKI-AvL)](https://onco.cc/institutions/nki/), [Oncode Institute](https://onco.cc/institutions/oncode-institute/)
- people: [Emile Voest](https://onco.cc/people/emile-voest/)
- key papers: [The Drug Rediscovery Protocol: approved cancer drugs used outside their licence, inside a national trial](https://onco.cc/key-papers/paper-drup-van-der-velden-nature-2019/), [Whole-genome sequencing of 2,520 metastatic tumours from the Dutch Hartwig cohort](https://onco.cc/key-papers/paper-priestley-hartwig-metastatic-wgs-nature-2019/)

---
JSON: https://onco.cc/api/v1/entities/drup.json