Protein test predicts NSCLC survival benefit for chemotherapy of erlotinib

Protein test predicts NSCLC survival benefit for chemotherapy of erlotinib -

By Sarah Pritchard, medwireNews Reporter

results of the Italian study confirm that a multivariate serum protein test predicts improved survival after treatment with chemotherapy compared to erlotinib in non-small cell lung cancer (NSCLC), but only in patients who are likely to have a poor outcome with the latter type of treatment.

Specifically, patients should not have poor survival rates with inhibitors of receptor tyrosine factor kinase epidermal growth (EGFR-TKI) by proteomic test survived a median of 3 months more during a chemotherapy treatment than their counterparts who received EGFR TKI erlotinib.

by contrast. Or treatment regimen was associated with superior overall survival in patients with predicted results were good

Vanesa Gregorc (Ospedale San Raffaele, Milan) and colleagues evaluated the predictive power of proteomics test - which compares the intensity of eight regions in the mass spectra of the patient with those of a reference whole - from 129 patients with NSCLC randomly assigned to receive chemotherapy (pemetrexed 500 mg / m ² or docetaxel 75 mg / m ² every 21 days) and 134 assigned to receive erlotinib (150 mg / day).

Overall, 70% of patients had a proteomic test classification of "good", while the remaining 30% were classified as "poor."

After a median of 32.4 months follow-up, overall survival did not differ significantly according to the type of treatment to 9.0 months in the chemotherapy group and 7.7 months in the group erlotinib. Conversely, patients with good proteomic test classification was significantly better overall survival than those with a classification of the poor, to 11.0 against 3.7 months.

In the test classification groups proteomic, patients classified as poor and treated with erlotinib were 72% more likely to die during follow-up than their counterparts who received chemotherapy (median overall survival 3.0 vs. 6.4 months), while Gregorc and colleagues found no significant difference in overall survival in patients with a good classification of proteomic test, approximately 11 months for both groups.

Furthermore, progression-free survival did not differ significantly by treatment regimen according proteomics test classification, the team added in on Lancet Oncology .

the researchers note that the biological justification for the difference in overall survival according proteomics classification is studied, but a "significant event" is that "patients who have a poor proteomics test classification have a systemic inflammatory response their tumors that promotes tumor growth and apoptotic resistance, "which could enhance the aggressiveness of the tumor and provide a way to" bypass EGFR blockade. "

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