In a nutshell
This study examined the effectiveness of a blood test (commercially known as VeriStrat) used for predicting the benefit of EGFR inhibitors in non-small cell lung cancer.
Some background
The epidermal growth factor receptor (EGFR) is involved in cell growth. Increased levels of EGFR can increase non-small cell lung cancer cell growth. These patients are likely to respond more to EGFR inhibitors (treatments that block the activity of EGFR, such as erlotinib [Tarceva]) compared to other treatments such as chemotherapy.
It is not clear whether patients who do not have increased EGFR levels also respond to EGFR inhibitors. Choosing the most effective treatment option is essential. Therefore, ways of predicting who might respond to different treatments are needed. Measuring the levels of different proteins in the blood may help to determine which therapy will be most effective in non-small cell lung cancer.
Methods & findings
This study included 263 patients with either stage 3 (spread to local lymph nodes) or 4 (spread to other areas of the body) non-small-cell lung cancer. All patients had previous treatment with chemotherapy. 129 patients were given chemotherapy and 134 were given an EGFR inhibitor (erlotinib). All of the patients had their blood proteins analyzed. This test predicted for each patient whether they were likely to respond to erlotinib (a “good” result) or not (a “poor” result).
Patients with a “poor” predicted benefit treated with erlotinib were 72% more likely to have a worse overall survival (time from treatment until death from any cause) than patients given chemotherapy. There were no significant differences between treatment types for patients with a “good” predicted benefit.
15% of patients given chemotherapy had low immune cell numbers in their blood. Skin irritation was seen in 16% of patients treated with erlotinib.
The bottom line
The authors concluded that the blood test predicts the benefit of EGFR inhibitors when treating non-small-cell lung cancer. The authors suggested that patients with a poor benefit prediction should not receive EGFR inhibitors. Patients with a good benefit prediction could receive either chemotherapy or EGFR inhibitors.
The fine print
This study was funded in part by the manufacturers of the blood test VeriStrat.
What’s next?
Discuss this test with your doctor when considering treatment options for your lung cancer.
Published By :
Lancet oncology
Date :
May 12, 2014
