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

F Grossi, E Rijavec, C Genova, G Barletta, F Biello, C Maggioni, G Burrafato, C Sini, M G Dal Bello, K Meyer, J Roder, H Roder, J Grigorieva, F Grossi, E Rijavec, C Genova, G Barletta, F Biello, C Maggioni, G Burrafato, C Sini, M G Dal Bello, K Meyer, J Roder, H Roder, J Grigorieva

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.

Conflict of interest statement

Julia Grigorieva, Krista Meyer, Joanna Roder, and Heinrich Roder are employees of Biodesix and hold company options. Francesco Grossi was compensated as a speaker for Eli Lilly, Bristol-Myers-Squibb, and received fees for participating in sponsored meetings and advisory boards of Bristol-Myers-Squibb. Carlo Genova received personal fees from Bristol-Myers-Squibb. The remaining authors declare no conflict of interest.

Figures

Figure 1
Figure 1
CONSORT diagram. Abbreviations: Cis/Pem=Cisplatin/Pemetrexed; Carbo/Pem=Carboplatin/Pemetrexed.
Figure 2
Figure 2
Kaplan–Meier curves of PFS and OS. (A) Progression-free survival by VeriStrat in overall population. (B) Overall survival by VeriStrat in overall population. (C) Progression-free survival by VeriStrat in treatment subgroups. (D) Overall survival by VeriStrat in treatment subgroups. Abbreviations: VSG=VeriStrat Good; VSP=VeriStrat Poor.

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