For patients with non-small cell lung cancer (NSCLC), a new proteomic test can predict who will benefit from chemotherapy versus erlotinib; however, neither treatment regimen demonstrated a superior overall survival in patients whose predicted outcomes were good.
The trial, which was performed by an Italian group from the Osepedale San Raffaele, in Milan, included 263 patients with NSCLC who were randomly assigned to receive either chemotherapy (129 patients: pemetrexed 500 mg/m2 or docetaxel 75 mg/m2 every 21 days) or erlotinib (134 patients: 150 mg/day). Using a multivariate serum protein test, eight regions of the patients’ mass spectra were compared with a reference set.
The results of the protein test showed that 70% of patients had a “good” classification, and 30% were classified as “poor”.
Predicted poor outcome patients who were treated with erlotinib were 72% more likely to have died during follow-up compared with those who received chemotherapy. However, there was no significant difference in overall survival among patients with a predicted good outcome (~11 months for both groups). Progression-free survival was not significantly different between treatment regimens based on test classification.
The researchers note that the biological rationale for the difference in overall survival according to proteomic classification is being studied.
Italian study results confirm that a multivariate serum protein test predicts improved survival after treatment with chemotherapy versus erlotinib for non-small-cell lung cancer (NSCLC), but only among patients who are likely to have a poor outcome with the latter treatment type.