{"entity":{"id":"tapur","kind":"trial","name":"TAPUR (Targeted Agent and Profiling Utilization Registry)","aka":["TAPUR Study","ASCO TAPUR"],"tldr":"TAPUR is the American oncology society's own trial: when a genomic test finds a change that an already approved drug targets in a different cancer, the drug's maker supplies it free and the outcome is recorded. It turns off-label guesses into organised evidence, and has told the field which matches work and which do not.","summary":"TAPUR opened in March 2016 as the first clinical trial run by the American Society of Clinical Oncology. Oncologists at more than a hundred community and academic sites order genomic testing as they normally would; if a patient's tumour has an alteration that one of the participating companies' approved drugs targets, and the match is on the protocol's list or is approved by a molecular tumour board, the patient receives the drug at no cost and is followed for response, progression and toxicity. Drugs have come from AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Genentech, Lilly, Merck, Pfizer, Seagen and Taiho, including pembrolizumab, nivolumab with ipilimumab, palbociclib, trastuzumab with pertuzumab, cetuximab, olaparib, talazoparib, vemurafenib with cobimetinib, sunitinib, axitinib, regorafenib, dasatinib, bosutinib, crizotinib and erlotinib. Each drug-by-tumour cohort follows a two-stage design: ten patients, expanding to 28 if enough show benefit.\n\nCohorts report continuously in JCO Precision Oncology and the Journal of Clinical Oncology. Positive cohorts include pembrolizumab in breast and other cancers with high tumour mutational burden, trastuzumab plus pertuzumab in colorectal cancer with ERBB2 amplification, and several immunotherapy cohorts; negative cohorts include palbociclib in non-small-cell lung cancer with CDKN2A loss, and cohorts of cetuximab, temsirolimus and other drugs where the target proved a poor predictor. A 2024 analysis reported high agreement between the trial's molecular tumour board reviewers, evidence that curated matching can be standardised.\n\nWhat TAPUR changed is the treatment of off-label targeted therapy as data rather than anecdote, at a cost far below a conventional trial, and it seeded sister programmes: the Netherlands' DRUP (2016) and Canada's CAPTUR use the same design and share results. What remains open is whether TAPUR-style evidence, which lacks a control arm, can support label changes or reimbursement; so far it has informed guidelines and directed drug companies toward or away from confirmatory trials.","status":"recruiting","asOf":"2026-09-17","links":[{"label":"ClinicalTrials.gov NCT02693535","url":"https://clinicaltrials.gov/study/NCT02693535"},{"label":"ASCO: TAPUR Study","url":"https://www.tapur.org"},{"label":"Gupta et al., JCO Precision Oncology 2022: pertuzumab plus trastuzumab in colorectal cancer with ERBB2 amplification or ERBB2/3 mutations (TAPUR)","url":"https://doi.org/10.1200/PO.22.00306"},{"label":"Ahn et al., JCO Precision Oncology 2020: palbociclib in non-small-cell lung cancer with CDKN2A alterations (TAPUR)","url":"https://doi.org/10.1200/PO.20.00037"},{"label":"Concordance in molecular tumor board case reviews in the ASCO TAPUR study, JCO Precision Oncology 2024","url":"https://doi.org/10.1200/PO.23.00615"}],"tags":[],"related":[],"cancers":["rare-cancers","colorectal","nsclc","breast-cancer"],"sections":[],"technologies":["cgp","variant-knowledgebases","checkpoint-inhibitor","cdk46-inhibitor","parp-inhibitor"],"targets":[],"drugs":["pembrolizumab","nivolumab","ipilimumab","palbociclib","trastuzumab","pertuzumab","cetuximab","olaparib","talazoparib","vemurafenib","cobimetinib","sunitinib","axitinib","regorafenib","dasatinib","bosutinib","crizotinib","erlotinib"],"companies":["astrazeneca","bayer","boehringer-ingelheim","bms","roche-genentech","eli-lilly","merck","pfizer","taiho"],"institutions":["asco"],"pathways":[],"terms":["master-protocol","basket-umbrella-platform","tumour-agnostic","tmb","real-world-evidence"],"trials":[],"people":[],"bottlenecks":["b-rare-cancers","b-trial-design"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT02693535","phase":"2","setting":"Advanced solid tumours, multiple myeloma and B-cell lymphoma with a genomic alteration that an approved targeted drug addresses in another cancer: the drug is given off-label in a pragmatic basket with cohorts by drug and tumour type","sponsor":"American Society of Clinical Oncology","result":"Continuous cohort reporting: positive signals for pembrolizumab in high tumour mutational burden cancers and trastuzumab plus pertuzumab in ERBB2-amplified colorectal cancer; palbociclib in CDKN2A-altered lung cancer and several other matches were negative.","yearReported":2020,"outcomes":[]},"route":"/trials/tapur/","neighbours":{"term":[{"id":"basket-umbrella-platform","kind":"term","name":"Basket, umbrella, and platform trials","route":"/terms/basket-umbrella-platform/"},{"id":"master-protocol","kind":"term","name":"Master protocol (platform, basket and umbrella trials)","route":"/terms/master-protocol/"},{"id":"rare-cancers","kind":"term","name":"Rare cancers","route":"/terms/rare-cancers/"},{"id":"real-world-evidence","kind":"term","name":"Real-world evidence","route":"/terms/real-world-evidence/"},{"id":"tmb","kind":"term","name":"Tumour mutational burden (TMB)","route":"/terms/tmb/"},{"id":"tumour-agnostic","kind":"term","name":"Tumour-agnostic (tissue-agnostic) approval","route":"/terms/tumour-agnostic/"}],"cancer":[{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"}],"technology":[{"id":"variant-knowledgebases","kind":"technology","name":"Cancer variant knowledgebases and molecular tumour boards","route":"/technologies/variant-knowledgebases/"},{"id":"cdk46-inhibitor","kind":"technology","name":"CDK4/6 inhibitors","route":"/technologies/cdk46-inhibitor/"},{"id":"cgp","kind":"technology","name":"Comprehensive genomic profiling","route":"/technologies/cgp/"},{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"},{"id":"parp-inhibitor","kind":"technology","name":"PARP inhibitors","route":"/technologies/parp-inhibitor/"}],"drug":[{"id":"axitinib","kind":"drug","name":"Axitinib","route":"/drugs/axitinib/"},{"id":"bosutinib","kind":"drug","name":"Bosutinib","route":"/drugs/bosutinib/"},{"id":"cetuximab","kind":"drug","name":"Cetuximab","route":"/drugs/cetuximab/"},{"id":"cobimetinib","kind":"drug","name":"Cobimetinib","route":"/drugs/cobimetinib/"},{"id":"crizotinib","kind":"drug","name":"Crizotinib","route":"/drugs/crizotinib/"},{"id":"dasatinib","kind":"drug","name":"Dasatinib","route":"/drugs/dasatinib/"},{"id":"erlotinib","kind":"drug","name":"Erlotinib","route":"/drugs/erlotinib/"},{"id":"ipilimumab","kind":"drug","name":"Ipilimumab","route":"/drugs/ipilimumab/"},{"id":"nivolumab","kind":"drug","name":"Nivolumab","route":"/drugs/nivolumab/"},{"id":"olaparib","kind":"drug","name":"Olaparib","route":"/drugs/olaparib/"},{"id":"palbociclib","kind":"drug","name":"Palbociclib","route":"/drugs/palbociclib/"},{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"},{"id":"pertuzumab","kind":"drug","name":"Pertuzumab","route":"/drugs/pertuzumab/"},{"id":"regorafenib","kind":"drug","name":"Regorafenib","route":"/drugs/regorafenib/"},{"id":"sunitinib","kind":"drug","name":"Sunitinib","route":"/drugs/sunitinib/"},{"id":"talazoparib","kind":"drug","name":"Talazoparib","route":"/drugs/talazoparib/"},{"id":"trastuzumab","kind":"drug","name":"Trastuzumab","route":"/drugs/trastuzumab/"},{"id":"vemurafenib","kind":"drug","name":"Vemurafenib","route":"/drugs/vemurafenib/"}],"company":[{"id":"astrazeneca","kind":"company","name":"AstraZeneca","route":"/companies/astrazeneca/"},{"id":"bayer","kind":"company","name":"Bayer","route":"/companies/bayer/"},{"id":"boehringer-ingelheim","kind":"company","name":"Boehringer Ingelheim","route":"/companies/boehringer-ingelheim/"},{"id":"bms","kind":"company","name":"Bristol Myers Squibb","route":"/companies/bms/"},{"id":"eli-lilly","kind":"company","name":"Eli Lilly (incl. Loxo)","route":"/companies/eli-lilly/"},{"id":"merck","kind":"company","name":"Merck & Co. (MSD)","route":"/companies/merck/"},{"id":"pfizer","kind":"company","name":"Pfizer (incl. Seagen)","route":"/companies/pfizer/"},{"id":"roche-genentech","kind":"company","name":"Roche / Genentech","route":"/companies/roche-genentech/"},{"id":"taiho","kind":"company","name":"Taiho Pharmaceutical (Otsuka)","route":"/companies/taiho/"}],"institution":[{"id":"asco","kind":"institution","name":"American Society of Clinical Oncology (ASCO)","route":"/institutions/asco/"}],"bottleneck":[{"id":"b-rare-cancers","kind":"bottleneck","name":"Rare and paediatric cancers without markets","route":"/bottlenecks/b-rare-cancers/"},{"id":"b-trial-design","kind":"bottleneck","name":"Trial design, endpoints and cost","route":"/bottlenecks/b-trial-design/"}],"trial":[{"id":"determine-trial","kind":"trial","name":"DETERMINE","route":"/trials/determine-trial/"}]}}