Serum proteomic test in advanced non-squamous non-small cell lung cancer treated in first line with standard chemotherapy

Abstract

Background:VeriStrat is a blood-based proteomic test with predictive and prognostic significance in second-line treatments for non-small cell lung cancer (NSCLC). This trial was designed to investigate the role of VeriStrat in first-line treatment of advanced NSCLC with standard chemotherapy. Here we present the results for 76 non-squamous patients treated with a combination of carboplatin or cisplatin with pemetrexed.Methods:The test-assigned classifications of VeriStrat Good or VeriStrat Poor to samples collected at baseline. The primary end point was progression-free survival (PFS); secondary end points included overall survival (OS) and objective response. Exploratory analyses of end points separately in carboplatin/pemetrexed and cisplatin/pemetrexed subgroups were also conducted.Results:Patients classified as VeriStrat Good had longer PFS and OS than VeriStrat Poor: 6.5 vs 1.6 months and 10.8 vs 3.4 months, respectively; the corresponding hazard ratios (HRs) were 0.36 (P<0.0001) and 0.26 (P<0.0001); they were also more likely to achieve objective response. Prognostic significance of VeriStrat was confirmed in multivariate analysis. Significant differences in OS and PFS between Veristrat classifications were also found when treatment subgroups were analysed separately.Conclusions:The trial demonstrated clinical utility of VeriStrat as a prognostic test for standard first-line chemotherapy of non-squamous advanced NSCLC.

Prediction of veristrat test in first-line therapy of pemetrexed based regimen for advanced lung adenocarcinoma patients

“…Patients classi ed as VS-G had longer PFS and OS than VS-P: 6.5 vs 1.6 months and 10.8 vs 3.4 months, respectively. [11] The PFS in our study was longer than previously reported data likely because pemetrexed maintainence therapy was administered in our study. PARAMOUNT study demonstrated that continuation maintenance therapy with pemetrexed was an effective and well tolerated treatment option for patients with advanced non-squamous NSCLC with good performance status who did not progress after induction therapy with pemetrexed plus cisplatin [25].…”

“…Previous studies have shown that VS was a valid method to predict the e cacy of chemotherapy or targeted therapy for advanced NSCLC patients [7][8][9][10][11]. However, so far there has been no study using VS method for the prediction of rst-line pemetrexed based chemotherapy plus for Chinese advanced lung adenocarcinoma patients without EGFR sensitizing mutations, ALK or ROS1 rearrangement.…”

Retrospective Assessment of a Serum Proteomic Test in a Phase III Study Comparing Erlotinib plus Placebo with Erlotinib plus Tivantinib (MARQUEE) in Previously Treated Patients with Advanced Non-Small Cell Lung Cancer

“…In retrospective analyses of multiple cohorts, Ver-iStrat is prognostic for OS and progression-free survival (PFS) in patients treated with front-line platinum-based chemotherapy [5]. The prognostic and predictive capabilities have been replicated in prospective analyses, in patients treated with front-line platinum and pemetrexed (VS-G median PFS, 6.5 mo; VS-P median PFS, 1.6 mo; HR, 0.36; p < .001) [6], and VeriStrat has been shown to be predictive of differential therapeutic benefit between second-line chemotherapy and erlotinib [7].…”

Tumor microenvironment as a potential source of clinical biomarkers in non-small cell lung cancer: can we use enemy territory at our advantage?

“…Indeed, the authors started by performing a wide analysis of the mass spectra observed in neoplastic and in healthy samples, and subsequently selected the potential biomarkers for further analyses. The mass spectrometry approach is able to screen a relevant number of peptides even in a limited number of samples, and hence potentially provide a huge amount of raw information; notably, mass spectrometry has already been employed in clinical studies designed to detect potential prognostic or predictive signatures in patients affected by advanced NSCLC, and this approach led to the identification of two distinct signatures able to discriminate between patients with good and poor outcomes while receiving chemotherapy or targeted agents; notably, such signatures were detected in plasma, which is often referred as another potential source of biomarkers, considered promising due to its easy accessibility (22,23). Mass spectrometry falls among those approaches able to simultaneously study multiple targets within a relatively limited amount of samples, which also include, above others, next generation sequencing and tissue microarrays (24).…”