{"entity":{"id":"triumph","kind":"trial","name":"TRIUMPH","aka":[],"tldr":"The first trial to let a blood test alone enrol people into a targeted treatment, and to show it selects as well as a tumour biopsy does.","summary":"TRIUMPH, run inside Japan's SCRUM-Japan screening platform, tested pertuzumab with trastuzumab in metastatic colorectal cancer whose HER2 amplification was confirmed prospectively either in tumour tissue or in circulating tumour DNA. Thirty patients were treated. The study met its primary endpoint with a confirmed objective response rate of 30 percent in the 27 tissue-positive patients and 28 percent in the 25 ctDNA-positive patients, against 0 percent in a matched real-world reference population on standard salvage therapy. Baseline ctDNA genotyping of HER2 copy number and concurrent oncogenic alterations, adjusted for tumour fraction, stratified patients for benefit about as well as tissue genotyping did, and a fall in ctDNA fraction at three weeks tracked response. A 2026 analysis of 66 enrolled patients found that previous anti-EGFR therapy (median overall survival 10.9 against 19.7 months) and resistance alterations detected in baseline ctDNA (no responses, median overall survival 7.6 against 16.5 months) both predict failure. TRIUMPH is the proof that liquid biopsy can be the entry criterion for a trial, not just a description of it.","status":"positive","asOf":"2026-09-24","links":[{"label":"TRIUMPH: circulating tumour DNA-guided treatment with pertuzumab plus trastuzumab for HER2-amplified metastatic colorectal cancer (Nature Medicine 2021)","url":"https://doi.org/10.1038/s41591-021-01553-w"},{"label":"TRIUMPH: prior anti-EGFR therapy and ctDNA resistance alterations predict failure (ESMO Open 2026)","url":"https://doi.org/10.1016/j.esmoop.2026.107734"},{"label":"UMIN000027887","url":"https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031885"}],"tags":[],"related":[],"cancers":["colorectal","her2-amplified-colorectal"],"sections":[],"technologies":["monoclonal-antibody","liquid-biopsy"],"targets":["her2"],"drugs":["pertuzumab","trastuzumab"],"companies":[],"institutions":["ncc-japan"],"pathways":[],"terms":["ctdna"],"trials":["heracles","mypathway","mountaineer","destiny-crc01"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"phase":"2","setting":"HER2-amplified metastatic colorectal cancer, amplification confirmed prospectively in tumour tissue or in circulating tumour DNA: pertuzumab with trastuzumab","sponsor":"National Cancer Center Hospital East / SCRUM-Japan","result":"Confirmed objective response 30 percent in tissue-positive and 28 percent in ctDNA-positive patients, against 0 percent in a matched real-world reference group.","yearReported":2021,"enrolled":30,"enrolledBasis":"treated","enrolledNote":"30 patients with HER2 amplification confirmed in tissue or circulating tumour DNA were treated; the trial is registered as UMIN000027887 and has no ClinicalTrials.gov record.","outcomes":[{"endpoint":"Confirmed objective response rate","primary":true,"unit":"percent","arms":[{"name":"Tissue HER2-positive","n":27,"value":30},{"name":"ctDNA HER2-positive","n":25,"value":28}],"source":"https://doi.org/10.1038/s41591-021-01553-w"}],"replication":"Consistent with HERACLES, MyPathway, MOUNTAINEER and DESTINY-CRC01 and CRC02 on the size of HER2-directed activity in this disease."},"route":"/trials/triumph/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"her2-amplified-colorectal","kind":"cancer","name":"HER2-amplified colorectal cancer","route":"/cancers/her2-amplified-colorectal/"}],"technology":[{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"monoclonal-antibody","kind":"technology","name":"Monoclonal antibodies","route":"/technologies/monoclonal-antibody/"}],"target":[{"id":"her2","kind":"target","name":"HER2","route":"/targets/her2/"}],"drug":[{"id":"pertuzumab","kind":"drug","name":"Pertuzumab","route":"/drugs/pertuzumab/"},{"id":"trastuzumab","kind":"drug","name":"Trastuzumab","route":"/drugs/trastuzumab/"}],"institution":[{"id":"ncc-japan","kind":"institution","name":"National Cancer Center Hospital","route":"/institutions/ncc-japan/"}],"term":[{"id":"ctdna","kind":"term","name":"Circulating tumour DNA (ctDNA)","route":"/terms/ctdna/"}],"trial":[{"id":"destiny-crc01","kind":"trial","name":"DESTINY-CRC01","route":"/trials/destiny-crc01/"},{"id":"heracles","kind":"trial","name":"HERACLES","route":"/trials/heracles/"},{"id":"mountaineer","kind":"trial","name":"MOUNTAINEER","route":"/trials/mountaineer/"},{"id":"mypathway","kind":"trial","name":"MyPathway","route":"/trials/mypathway/"}]}}