ClinicalTrials.gg
RecruitingNCT05722886DETERMINEUpdated Jul 1, 2026

DETERMINE (Determining Extended Therapeutic Indications for Existing Drugs in Rare Molecularly Defined Indications Using a National Evaluation Platform Trial) - Master Screening Protocol

A Phase 2/3 interventional study of Alectinib and Atezolizumab in Haematological Malignancy and Solid Tumour, sponsored by Cancer Research UK. Recruiting at 27 sites in United Kingdom. Per ClinicalTrials.gov, last updated 2026-07-01.

Sponsored by Cancer Research UK · Phase 2/3, Interventional, and Treatment

From the registry’s dates

  • Started Mar 2023; still recruiting 3 years 8 months later.
Phase
Phase 2/3
Study type
Interventional
Enrollment
825
Allocation
Non-randomized
Sex
All
01

Study summary

DETERMINE is an open-label phase II/III trial. It will look at targeted treatments in rare cancers or common cancers with rare genetic change (mutation). Patients must have a cancer with an identified mutation. This could be found during routine testing or as part of another research programme. The DETERMINE trial will recruit adults, teenagers and children. If a drug is found to benefit a new patient group, the study team will work with the NHS and the Cancer Drugs Funds to see if these drugs can be available for patients in the future. This clinicaltrials.gov record refers to the Overall Trial Protocol (Master Screening Record), additional records will be added to clinicaltrials.gov for each treatment arm.

Read the detailed description

DETERMINE is an umbrella-basket platform trial to evaluate the efficacy of licensed targeted therapies in rare* adult, paediatric and teenage/young adult (TYA) cancers with actionable genomic alterations, including common cancers with rare actionable alterations.

*Rare is defined generally as incidence less than 6 cases in 100,000 patients (includes paediatric and TYA cancers) or common cancers with rare alterations.

The number of treatment arms opened will depend on the number of licensed medicines identified for inclusion. Each trial cohort has a target sample size of 30 evaluable patients. Sub-cohorts may be defined and further expanded to a target of 30 evaluable patients each.

This clinicaltrials.gov record refers to the Overall Trial Protocol (Master Screening Record), please refer to the references section for links to the individual treatment arm records.

The main aims of the clinical trial arms are:

  • To describe the anti-cancer activity of licensed targeted drugs outside their licensed indication.
  • To assess the safety and adverse event (AE) profile of licensed, targeted anti-cancer drugs in the target population.
  • To understand biological mechanisms for response and resistance to targeted therapies.
  • To evaluate the quality of life (QoL) of target populations receiving the licensed, targeted anti-cancer drugs.

This Master Screening Record will capture the number of patients with a cancer containing the appropriate genetic alteration that have been successfully allocated and consented to each arm. The trial results (according to the protocol defined outcome measures) will be reported per-arm for each treatment arm.

The ultimate aim is to translate positive clinical findings to the NHS to provide new treatment options for rare adult, paediatric and TYA cancers.

02

Conditions studied

  • Haematological Malignancy
  • Solid Tumour

Keywords

  • Adult
  • Alectinib
  • ALK Tyrosine Kinase Receptor
  • Antineoplastic Agents
  • Atezolizumab
  • BRAF Kinase
  • Cancer
  • Child
  • CMMRD
  • Cobimetinib
  • Entrectinib
  • Genes, HER2
  • Immune Checkpoint Inhibitors
  • Immunological
  • Lymphoproliferative Disorders
  • Malignancy
  • Malignant Neoplasms
  • MSI
  • Molecular Targeted Therapy
  • Mutation
  • Neoplasms by Histologic Type
  • Neoplasms by Site
  • Paediatric
  • Pertuzumab
  • Precision Medicine
  • Protein Kinase Inhibitors
  • Rare
  • ROS1 protein, human
  • TMB
  • Trastuzumab
  • Tumour-agnostic
  • Vemurafenib
  • Young adult
  • Capmatinib
  • MET
  • Dabrafenib
  • Trametinib
03

In context

Hematologic Neoplasms

1,444 studies on the registry are indexed under Hematologic Neoplasms; 420 are open to participants now.

This study's planned enrollment of 825 is above the median of 46 across 1,044 interventional studies indexed under Hematologic Neoplasms.

Browse Hematologic Neoplasms studies →

Lead sponsor

Cancer Research UK is the lead sponsor of 83 studies on the registry; 12 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

THE PATIENT MUST FULFIL THE ELIGIBILITY CRITERIA OUTLINED BELOW AND WITHIN THE SPECIFIC TREATMENT ARM APPENDIX TO WHICH THEY ARE ENROLLED.

Core Inclusion Criteria:

  1. Any patient (adult patients or children and TYA as defined in each treatment arm appendix) with proven locally advanced or cancer (solid tumour or haematological ) who has:

    1. exhausted (or declined) standard-of-care treatment options.
    2. or for whom no effective standard treatment is available.
    3. and whose disease has progressed or is . Exceptional circumstances may apply as described in the protocol.
  2. Diagnosis of a rare cancer harbouring an actionable genomic alteration, or common cancer types with rare actionable genomic alterations, that has been identified using a validated next-generation sequencing method and for which there is a relevant open treatment arm within the DETERMINE trial.
  3. of at least three months.
  4. Patients are able to provide written (signed and dated) and be capable of co-operating with treatment and follow-up. For patients under 16 years old, the parent or legal guardian will be asked to provide written informed consent and the patient will be asked to provide age-appropriate assent (written or verbal, commensurate with age and level of understanding).
  5. Patients with objectively evaluable or , according to an assessment method appropriate for their cancer type.
  6. Patients must provide a fresh tissue at baseline and blood samples for translational research. Note that for patients with haematological malignancies or neuroblastomas, blood, bone marrow and/or trephine, lymph node or lump biopsy samples may be taken. For patients with haematological malignancies, a skin punch biopsy may also be taken.
  7. (ECOG) performance status 0-1 (ECOG performance status 2 may be considered on an individual basis) (adults), score ≥50% (TYA) or Lansky Play scales ≥50% (\<12 years). Please see specific treatment arm appendices for any variations on this criterion and for definitions of adult and paediatric populations. Note: Paediatric patients: patients with Central Nervous System (CNS) tumours and a stable neurological deficit may be eligible with a performance status below 50%, at the discretion of the Investigator. In such cases, the deficit must be stable for at least 7 days prior to trial enrolment and be assessed by the local investigator as due to tumour or due to a post-surgical AE.
  8. Women of are eligible provided that they meet the following criteria:

    • Have a negative serum or urine pregnancy test before enrolment and
    • Agree to the methods and duration of use of those methods, as specified in each treatment arm appendix.
  9. Male patients with partners of childbearing potential are eligible provided that they agree to the birth control methods and duration of use of those methods, as specified in each treatment arm appendix.

Core exclusion criteria:

  1. Ongoing AEs Common Terminology Criteria of Adverse Events () Grade ≥2 attributable to previous anti-cancer treatments. Exceptions to this are any clinically stable AEs, which in the opinion of the Investigator should not exclude the patient.
  2. At high medical risk, in the opinion of the Investigator, because of non-malignant systemic disease (including active uncontrolled infection).
  3. Female patients who are pregnant, breastfeeding or planning to become pregnant or male patients with a partner who is a woman of childbearing potential and is planning to become pregnant during the trial or following the last dose of IMP, as specified in each treatment arm appendix.
  4. Is (or plans to be) a patient in another interventional clinical trial, whilst taking part in this trial. Participation in an observational trial which does not involve administration of an Medicinal Product (IMP) and which, in the opinion of the local Investigator, would not place an unacceptable burden on the patient would be acceptable e.g. sample collection* or QoL studies.

    *for paediatric patients participating in other studies involving tissue/circulating tumour (ct) DNA/other blood collection, consideration would need to be given to the total blood volumes collected (as per the European Medicines Agency blood volume limits for children).

  5. Co-administration of anti-cancer therapies other than those administered in this trial (with the exception of lifelong hormone suppression such as luteinising hormone agonists/analogues in prostate cancer).
  6. Radiotherapy (except for palliative reasons) or chemotherapy, endocrine therapy (except when given for conditions other than malignant disease; e.g. thyroid replacement for hypothyroidism, hydrocortisone for cortisol deficiency/panhypopituitarism), nitrosoureas, mitomycin-C, immunotherapy and molecularly targeted agents or other IMPs within 4 weeks or 5 half-lives (whichever is the shorter).
  7. Rapidly progressing or symptomatically deteriorating . Patients with previously treated brain metastases are eligible, provided the patient has not experienced a seizure or had a change in neurological status within the 14 days (for adult patients) or 7 days (for paediatric patients) prior to the start of IMP administration. Such patients must be non-dependent on or on a stable or reducing dose of steroid treatment for at least 14 days (or 7 days for paediatric patients) prior to the start of IMP administration. Primary brain or CNS malignancies are allowed providing the patient is clinically stable (if requiring corticosteroids must be at stable or decreasing doses for at least 14 days for adults and 7 days for paediatric patients prior to the start of IMP administration). Patients who have received brain irradiation must have completed whole-brain radiotherapy and/or stereotactic radiosurgery at least 14 days prior to the start of IMP administration.
  8. Any other condition which, in the opinion of the local Investigator, would not be in the best interests of the patient.
Terms in these criteria, in plain language(17)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

05

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Single group
Masking
None (open label)
Enrollment
825 participants (estimated)

Study arms

  • Experimental
    Treatment Arm 1: Alectinib

    This alectinib treatment arm is for adult, paediatric and TYA patients with ALK-positive cancers.

    Drug: Alectinib

  • Experimental
    Treatment Arm 2: Atezolizumab

    This atezolizumab treatment arm is for adult, paediatric and TYA patients with cancers with high tumour mutational burden (TMB) or microsatellite instability high (MSI-high) or proven (previously diagnosed) constitutional mismatch repair deficiency (CMMRD).

    Drug: Atezolizumab

  • Experimental
    Treatment Arm 3: Entrectinib

    This entrectinib treatment arm is for adult, paediatric and TYA patients with ROS1 gene fusion-positive cancers.

    Drug: Entrectinib

  • Experimental
    Treatment Arm 4: Trastuzumab in combination with pertuzumab

    This trastuzumab and pertuzumab treatment arm is for adult, paediatric and TYA patients with cancers with HER2 amplification or activating mutations.

    Drug: Trastuzumab in combination with pertuzumab

  • Experimental
    Treatment Arm 5: Vemurafenib in combination with cobimetinib

    This vemurafenib and cobimetinib treatment arm is for BRAF V600 mutation-positive cancers occurring in adults only.

    Drug: Vemurafenib in combination with cobimetinib

  • Experimental
    Treatment Arm 6: Capmatinib

    This capmatinib treatment arm is for adult patients with cancers harbouring MET dysregulations.

    Drug: Capmatinib

  • Experimental
    Treatment Arm 7: Dabrafenib in combination with trametinib

    This dabrafenib and trametinib treatment arm is for adult, paediatric and TYA patients with cancers harbouring BRAF V600 mutations.

    Drug: Dabrafenib in combination with trametinib

Interventions

  • Adult patients will be administered alectinib orally at a dose of 600 mg (four 150 mg capsules) twice daily. Paediatric patients with a body weight ≥40 kg and who are able to swallow the capsules will be administered alectinib orally at a dose of 600 mg (four 150 mg capsules) twice daily. Each cycle of treatment will consist of 28 days and patients may continue on treatment until disease progression without clinical benefit, unacceptable AEs or withdrawal of consent.

    Also known as: Alecensa

  • Adult patients will receive 1200 mg of atezolizumab intravenously every 21 days. Paediatric patients will receive atezolizumab at a dose of 15 mg/kg (maximum 1200 mg) every 21 days. Patients may continue on treatment until disease progression without clinical benefit, unacceptable AEs or withdrawal of consent.

    Also known as: Tecentriq

  • Adult and paediatric patients with body surface area (BSA) ≥1.51 m\^2 will receive entrectinib orally at a dose of 600 mg daily dose (three 200 mg capsules per day). Paediatric patients with BSA \<1.51 m\^2 will receive a dose adjusted for BSA. Each cycle of treatment will consist of 28 days and patients may continue until disease progression without clinical benefit, unacceptable AEs or withdrawal of consent.

    Also known as: Rozlytrek

  • DrugTrastuzumab in combination with pertuzumab

    Drug pages: Trastuzumab · Pertuzumab

    The initial loading dose of trastuzumab is 8 mg/kg body weight followed thereafter by a maintenance dose of 6 mg/kg body weight administered intravenously every 21 days. The initial loading dose of pertuzumab is 840 mg followed thereafter by a maintenance dose of 420 mg administered intravenously every 21 days. Paediatric patients will receive a dose of pertuzumab adjusted by body weight. Patients may continue until disease progression without clinical benefit, unacceptable AEs or withdrawal of consent.

    Also known as: Herceptin in combination with Perjeta

  • DrugVemurafenib in combination with cobimetinib

    Drug pages: Vemurafenib · Cobimetinib

    Patients will receive vemurafenib at a dose of 960 mg (four tablets of 240 mg) orally on a twice daily schedule throughout a 28-day cycle. Patients will receive cobimetinib at a dose of 60 mg (three tablets of 20 mg) to be taken orally, once daily for 21 consecutive days (days 1 to 21 in each 28-day cycle); followed by a 7-day break. Patients may continue on treatment until disease progression without clinical benefit, unacceptable AEs or withdrawal of consent.

    Also known as: Zelboraf in combination with Cotellic

  • Patients will receive capmatinib orally at a daily dose of 800 mg consisting of 400 mg (two 200 mg tablets) twice daily. Each cycle of treatment will consist of 28 days and patients may continue on treatment until disease progression without clinical benefit, unacceptable AEs or withdrawal of consent.

    Also known as: Tabrecta

  • DrugDabrafenib in combination with trametinib

    Drug pages: Dabrafenib · Trametinib

    Adult patients (≥18 years) will receive dabrafenib at a dose of 150 mg (two 75 mg tablets) twice daily (total daily dose 300 mg). Paediatric patients (1 to \<12 years) will receive dabrafenib dose adjusted by body weight as 10 mg dispersible tablets orally twice daily. Paediatric patients (≥12 years) and TYA patients (16 to \<18 years) will have the option to receive adult or paediatric dosing. Adult patients will receive trametinib at a daily dose of 2 mg (one 2 mg tablet) orally once daily (total daily dose 2 mg). Paediatric patients receive trametinib at a dose adjusted by body weight as 0.05 mg/m\^2 powder for oral solution twice daily. Paediatric patients (≥12 years) and TYA patients (16 to \<18 years) will have the option to receive adult or paediatric dosing. Each cycle of treatment will consist of 28 days. Patients may continue until disease progression without clinical benefit, unacceptable AEs or withdrawal of consent.

    Also known as: Tafinlar in combination with Mekinist, Finlee in combination with Spexotras

06

What researchers measure

Primary outcomes

  1. Number of patients who consent to each arm.

    This is a master screening entry with sub-study entries to capture the results of each arm. As such a primary outcome measure for this entry is not relevant, however this entry will be used to report the number of patients with a cancer containing the appropriate genetic alteration that have been successfully allocated and consented to each arm.

    Time frame: Up to 5 years.

07

Study locations

26 of 27 sites recruiting
08

References and documents

Individual participant data

Plan to share: Yes — Individual de-identified patient data will be shared with researchers whose proposed use of the data is approved by a review committee of the Sponsor.

Supporting information: Study protocol, Statistical analysis plan, Informed consent form

Time frame: All requests made within 5 years from last patient last visit for each of the treatment arms will be considered (refer to individual treatment arm records); requests made subsequently will be considered where possible.

Access criteria: When a request has been approved, Cancer Research UK will provide access to the de-identified individual patient-level data and appropriate supporting information. A signed Data Sharing Agreement must be in place before accessing requested information. Requests should be submitted to drugdev@cancer.org.uk

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Mar 2023 (actual). Primary completion is estimated for Oct 2029, 79 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 24, 2022
First posted
Feb 10, 2023
StartActual
Mar 1, 2023
Primary completionEst.
Oct 2029
CompletionEst.
Oct 2029
Last update
Jul 1, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 1, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05722886
Lead sponsor
Cancer Research UK
Responsible party
Sponsor
First posted
Feb 10, 2023
Start date
Mar 1, 2023
Primary completion
Oct 2029 (estimated)
Completion
Oct 2029 (estimated)
Last update
Jul 1, 2026

Study contacts

Aida Sarmiento Castro
Contact
determine@cancer.org.uk
+44 207 242 0200
Matthew Krebs, Dr
principal investigator · The Christie Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drugs tested here: Alectinib · Atezolizumab · Entrectinib · Trastuzumab · Pertuzumab · Vemurafenib · Cobimetinib · Capmatinib · Dabrafenib · Trametinib

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