A blood-based proteomic test offers prognostic information and optimal second-line treatment guidance for patients with squamous cell carcinoma (SCC) of the lung, according to research published in Lung Cancer (July 2017;109:101-108).
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Identifying biomarkers associated with clinical benefit is crucial in developing optimal treatment choices for patients with SCC of the lung after first-line chemotherapy. VeriStrat (Biodesix) is a prognostic test for patients with advanced non-small cell lung cancer that characterizes patients as either VeriStrat-Good (VS-G) or VeriStrat-Poor (VS-P) based on tumor characteristics and may help develop optimal treatment options in SCC populations.
Shirish Gadgeel, MD, Karmanos Cancer Institute, Wayne State University (Detroit, MI), and colleagues conducted a study to assess the ability of VeriStrat to predict differential clinical benefit with afatinib versus erlotinib, and the association of VeriStrat status with clinical outcomes regardless of EGFR-TKI used. Researchers performed a retrospective analysis of the phase III LUX-Lung 8 trial, in which 675 patients were classified as either VS-G or VS-P. Overall survival (OS), progression-free survival (PFS), and other endpoints were assessed with regard to pretreatment VeriStrat status.
Results of the analysis showed that in both the afatinib and erlotinib treatment arms, patients classified as VS-G had longer OS and PFS than patients classified as VS-P. In a comparison across therapies, researchers found that patients classified as VS-G had significantly higher OS and PFS in the afatinib arm compared with the erlotinib arm; median OS was 11.5 months for afatinib and 8.9 months for erlotinib (HR, 0.787; 95% CI, 0.632-0.979; P = 0.0312) while median PFS was 3.3 versus 2.0, respectively.
Researchers acknowledged that median OS and PFS were not significantly different among treatment arms for the patients classified as VS-P.
Multivariate analysis showed that VeriStrat was an independent predictor of OS and PFS in patients with SCC of the lung treated with afatinib.
Authors of the study concluded that VS-G classification is strongly associated with favorable survival outcomes with either afatinib or erlotinib compared with VS-P classification. For those patients with VS-G classification, survival outcomes with afatinib are superior.
“VeriStrat classification may guide treatment decisions in patients with SCC of the lung,” they wrote.—Zachary Bessette
