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K. Meyer



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    P2.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 207)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P2.01-057 - Serum Mass-Spectrometry Test in First-Line Advanced Non-Small Cell Lung Cancer Patients Treated with Standard Chemotherapy Regimens (ID 2309)

      09:30 - 17:00  |  Author(s): K. Meyer

      • Abstract

      Background:
      The mass-spectrometry based serum test VeriStrat® (VS) was developed using samples from non-small cell lung cancer (NSCLC) patients (pts) treated with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs); VS was shown to be prognostic in several tumors and predictive of differential overall survival (OS) benefit for erlotinib vs. chemotherapy (CT) in 2[nd] line for NSCLC. We investigated the role of VS in pts receiving Cisplatin (CDDP) or Carboplatin (CBDCA) plus Pemetrexed (P) as 1[st] line for advanced, non-squamous NSCLC.

      Methods:
      VeriStrat classification was available for 55 eligible pts, who were classified as VS Good (VSG) or VS Poor (VSP); VS testing was done blinded to clinical data. Progression-free survival (PFS) and OS were analyzed by Kaplan-Meier method and compared using log-rank p-values; Cox models were used in multivariate analysis. Association with categorical variables was analyzed by Fisher’s exact test.

      Results:
      36 (65%) pts were classified as VSG and 19 (35%) as VSP. In the overall population, median PFS was 6.1 months (mo) for VSG vs.1.3 mo for VSP (hazard ratio (HR) 0.39 [0.21-0.70], p=0.001 ); adjusted HR (AHR) 0.43 [0.21-0.91], p=0.026). Median OS was 10.6 mo for VSG vs. 3.1 mo for VSP (HR 0.26 [0.14-0.50], p<0.001; AHR 0.20 [0.09-0.47], p<0.001). A similar relationship was found in both treatments: In CBDCA-P median PFS in VSG and VSP was 3.9 mo and 1.6 mo respectively (HR 0.34 [0.14-0.81], p=0.011); median OS was 10.0 mo in VSG and 2.0 mo in VSP (HR 0.26 [0.11-0.61], p=0.001). In CDDP-P median PFS was 6.6 mo in VSG and 1.2 mo in VSP (HR 0.52 [0.20-1.33], p=0.161), median OS was 12.3 mo in VSG, 3.5 mo in VSP (HR 0.25 [0.09-0.70], p=0.005).When compared within VS groups, no statistically significant differences between CBDCA-P and CDDP-P was found either for PFS (VSG: p=0.471, VSP: p=0.493) or OS (VSG: p=0.319, VSP: p=0.429). VS was significantly associated with disease control rate (p=0.003) and objective response (p=0.021).

      Population (N°) Median PFS (months) Hazard ratio, p Median OS (months) Hazard ratio, p
      VSG VSP VSG VSP
      Overall (55) 6.1 1.3 0.39 [0.21-0.70] p=0.001 10.6 3.1 0.26 [0.14-0.50] p<0.001
      CBDCA-P (30) 3.9 1.6 0.34 [0.14-0.84] p=0.011 10.0 2.0 0.26 [0.11-0.61] p=0.001
      CDDP-P (25) 6.6 1.2 0.52 [0.20-1.33] p=0.161 12.3 3.5 0.25 [0.09-0.70] p=0.005


      Conclusion:
      VeriStrat has prognostic significance in platinum-based CT: overall, VSP pts have significantly shorter PFS and OS than VSG pts. In each VS group, CDDP-P and CBDCA-P showed similar behavior. Further research is needed to find alternative treatments to improve outcomes for VSP pts. ClinicalTrials.gov Identifier: NCT02055144.