Ticiana A Leal1, Angela C Argento2, Krish Bhadra3, D Kyle Hogarth4, Julia Grigorieva5, Rachel M Hartfield5, Robert C McDonald6, Philip D Bonomi7. 1. Carbone Cancer Center, University of Wisconsin, Madison, WI, USA. 2. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 3. Rees Skillern Cancer Institute, CHI Memorial, Chattanooga, TN, USA. 4. Department of Medicine, University of Chicago, Chicago, IL, USA. 5. Biodesix, Inc., Boulder, CO, USA. 6. School of Medicine, Indiana University, Indianapolis, IN, USA. 7. Rush University Medical Center, Chicago, IL, USA.
Abstract
OBJECTIVE: Timely assessment of patient-specific prognosis is critical to oncology care involving a shared decision-making approach, but clinical prognostic factors traditionally used in NSCLC have limitations. We examine a proteomic test to address these limitations. METHODS: This study examines the prognostic performance of the VeriStrat blood-based proteomic test that measures the inflammatory disease state of patients with advanced NSCLC. A systematic literature review (SLR) was performed, yielding cohorts in which the hazard ratio (HR) was reported for overall survival (OS) of patients with VeriStrat Poor (VSPoor) test results versus VeriStrat Good (VSGood). A study-level meta-analysis of OS HRs was performed in subgroups defined by lines of therapy and treatment regimens. RESULTS: Twenty-four cohorts met SLR criteria. Meta-analyses in five subgroups (first-line platinum-based chemotherapy, second-line single-agent chemotherapy, first-line EGFR-tyrosine kinase inhibitor (TKI) therapy, and second- and higher-line TKI therapy, and best supportive care) resulted in statistically significant (p ≤ .001) summary effect sizes for OS HRs of 0.42, 0.54, 0.41, 0.52, and 0.50, respectively, indicating increased OS by about two-fold for patients who test VSGood. No significant heterogeneity was seen in any subgroup (p > .05). CONCLUSIONS: Advanced NSCLC patients classified VSGood have significantly longer OS than those classified VSPoor. The summary effect size for OS HRs around 0.4-0.5 indicates that the expected median survival of those with a VSGood classification is approximately 2-2.5 times as long as those with VSPoor. The robust prognostic performance of the VeriStrat test across various lines of therapy and treatment regimens has clinical implications for treatment shared decision-making and potential for novel treatment strategies.
OBJECTIVE: Timely assessment of patient-specific prognosis is critical to oncology care involving a shared decision-making approach, but clinical prognostic factors traditionally used in NSCLC have limitations. We examine a proteomic test to address these limitations. METHODS: This study examines the prognostic performance of the VeriStrat blood-based proteomic test that measures the inflammatory disease state of patients with advanced NSCLC. A systematic literature review (SLR) was performed, yielding cohorts in which the hazard ratio (HR) was reported for overall survival (OS) of patients with VeriStrat Poor (VSPoor) test results versus VeriStrat Good (VSGood). A study-level meta-analysis of OS HRs was performed in subgroups defined by lines of therapy and treatment regimens. RESULTS: Twenty-four cohorts met SLR criteria. Meta-analyses in five subgroups (first-line platinum-based chemotherapy, second-line single-agent chemotherapy, first-line EGFR-tyrosine kinase inhibitor (TKI) therapy, and second- and higher-line TKI therapy, and best supportive care) resulted in statistically significant (p ≤ .001) summary effect sizes for OS HRs of 0.42, 0.54, 0.41, 0.52, and 0.50, respectively, indicating increased OS by about two-fold for patients who test VSGood. No significant heterogeneity was seen in any subgroup (p > .05). CONCLUSIONS: Advanced NSCLCpatients classified VSGood have significantly longer OS than those classified VSPoor. The summary effect size for OS HRs around 0.4-0.5 indicates that the expected median survival of those with a VSGood classification is approximately 2-2.5 times as long as those with VSPoor. The robust prognostic performance of the VeriStrat test across various lines of therapy and treatment regimens has clinical implications for treatment shared decision-making and potential for novel treatment strategies.
Entities:
Keywords:
Meta-analysis; NSCLC; VeriStrat; prognosis; proteomic test
Authors: Patricia Rich; R Brian Mitchell; Eric Schaefer; Paul R Walker; John W Dubay; Jason Boyd; David Oubre; Ray Page; Mazen Khalil; Suman Sinha; Scott Boniol; Hafez Halawani; Edgardo S Santos; Warren Brenner; James M Orsini; Emily Pauli; Jonathan Goldberg; Andrea Veatch; Mitchell Haut; Bassam Ghabach; Savita Bidyasar; Maria Quejada; Waseemullah Khan; Kan Huang; Linda Traylor; Wallace Akerley Journal: J Immunother Cancer Date: 2021-10 Impact factor: 13.751