{"entity":{"id":"gary-middleton","kind":"person","name":"Gary Middleton","aka":[],"tldr":"The Birmingham oncologist who ran the National Lung Matrix Trial, the largest umbrella trial in lung cancer, and published the honest answer: most drug-biomarker pairs did not work.","summary":"Gary Middleton is Professor of Medical Oncology in the Department of Immunology and Immunotherapy at the University of Birmingham, an honorary consultant oncologist at University Hospitals Birmingham and director of the Birmingham Experimental Cancer Medicine Centre. He was chief investigator of the National Lung Matrix Trial, run from the Cancer Research UK Clinical Trials Unit in Birmingham and delivered across the experimental cancer medicine centre network.\n\nThe trial screened 5,467 patients, found 2,007 molecularly eligible and gave genotype-matched therapy to 302 across 19 drug-biomarker cohorts. Its 2020 Nature paper said plainly that despite the preclinical rationale only a limited number of combinations showed clinically relevant benefit, and that those were concentrated in lung cancers associated with minimal tobacco exposure. A later arm reported that vistusertib, an mTORC1 and mTORC2 inhibitor, could not be recommended in STK11-deficient disease. He is translational lead for DETERMINE, runs a ketogenic diet trial in squamous lung cancer, and his group published the first cellular predictive biomarker for severe immune-related adverse events in lung cancer.","asOf":"2026-09-25","links":[{"label":"University of Birmingham staff page","url":"https://www.birmingham.ac.uk/staff/profiles/immunology-immunotherapy/middleton-gary"}],"tags":["lung","trialist","uk"],"related":["sanjay-popat","alastair-greystoke"],"cancers":["nsclc","lung-cancer","kras-g12c-nsclc"],"sections":["targeted-therapy","immunotherapy"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["birmingham-cancer-centre"],"pathways":[],"terms":[],"trials":["national-lung-matrix-trial"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"role":"Professor of Medical Oncology, University of Birmingham; Honorary Consultant Oncologist, University Hospitals Birmingham; Director of the Birmingham Experimental Cancer Medicine Centre","institutionId":"birmingham-cancer-centre","specialisms":["Umbrella and platform trials","Immuno-oncology in lung cancer","Biomarker-directed therapy"],"profiles":[{"label":"University of Birmingham staff page","url":"https://www.birmingham.ac.uk/staff/profiles/immunology-immunotherapy/middleton-gary"}],"papers":[{"title":"The National Lung Matrix Trial of personalized therapy in lung cancer","journal":"Nature","year":2020,"doi":"10.1038/s41586-020-2481-8"},{"title":"A phase II trial of mTORC1/2 inhibition in STK11 deficient non small cell lung cancer","journal":"npj Precision Oncology","year":2025,"doi":"10.1038/s41698-025-00814-y"}]},"route":"/people/gary-middleton/","neighbours":{"person":[{"id":"alastair-greystoke","kind":"person","name":"Alastair Greystoke","route":"/people/alastair-greystoke/"},{"id":"sanjay-popat","kind":"person","name":"Sanjay Popat","route":"/people/sanjay-popat/"}],"cancer":[{"id":"kras-g12c-nsclc","kind":"cancer","name":"KRAS G12C-mutant non-small-cell lung cancer","route":"/cancers/kras-g12c-nsclc/"},{"id":"lung-cancer","kind":"cancer","name":"Lung cancer (all types)","route":"/cancers/lung-cancer/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"}],"section":[{"id":"immunotherapy","kind":"section","name":"Immunotherapy","route":"/fronts/immunotherapy/"},{"id":"targeted-therapy","kind":"section","name":"Targeted Therapy","route":"/fronts/targeted-therapy/"}],"institution":[{"id":"birmingham-cancer-centre","kind":"institution","name":"University Hospitals Birmingham / University of Birmingham Cancer Research Centre","route":"/institutions/birmingham-cancer-centre/"}],"trial":[{"id":"national-lung-matrix-trial","kind":"trial","name":"National Lung Matrix Trial","route":"/trials/national-lung-matrix-trial/"}]}}