TARGET National
TARGET National is the United Kingdom's programme to sequence the blood and tumour of thousands of people with advanced cancer so they can be steered into early trials of drugs that fit their tumour's changes. It grew out of a Manchester pilot that showed a blood test alone could find a trial for one patient in ten.
Overview
TARGET began at the Christie and the Cancer Research UK Manchester Institute, led by Matthew Krebs and Caroline Dive, as a single-centre study of whether circulating tumour DNA could support selection for phase 1 trials. The 2019 Nature Medicine report on the first 100 patients found that a 641-gene plasma panel and tissue sequencing together identified an actionable alteration in 41 patients and matched 11 of them to a phase 1 trial, and that plasma and tissue results agreed well when circulating tumour DNA was abundant.
TARGET National opened in June 2021 with Cancer Research UK funding and a target of 6,000 patients recruited through experimental cancer medicine centres across the country. Every participant has blood and, where available, tissue sequenced, results are reviewed by a national molecular tumour board and matched to open early-phase trials, and the linked clinical and genomic data build a research resource on how advanced cancers evolve under treatment. It is observational: the trials patients enter are separate studies.
The programme's contribution is logistics rather than a drug result: a common national pipeline from blood draw to trial slot, faster than the tissue-based screening of the National Lung Matrix Trial, and a cohort that DETERMINE and other United Kingdom platforms can draw on. What remains to be shown is how many screened patients actually reach a matched trial, and whether the pipeline shortens the time from progression to experimental treatment enough to change outcomes.
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