1. Prognostic performance of proteomic testing in advanced non-small cell lung cancer: a systematic literature review and meta-analysis
- Author
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Angela Christine Argento, Rachel M. Hartfield, Krish Bhadra, Ticiana A. Leal, Philip Bonomi, Robert C. McDonald, Julia Grigorieva, and D. Kyle Hogarth
- Subjects
Oncology ,Proteomics ,medicine.medical_specialty ,Lung Neoplasms ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Carcinoma, Non-Small-Cell Lung ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,030212 general & internal medicine ,Lung cancer ,Protein Kinase Inhibitors ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,Systematic review ,Meta-analysis ,Female ,Non small cell ,Veristrat ,business - Abstract
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.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.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 (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.
- Published
- 2020