Prospective correlative study of FDG-PET SUV and proteomic profile (VeriStrat) of non-small cell lung cancer patients treated with erlotinib.

Lung Cancer - Non-Small Cell Metastatic
Session Type and Session Title: 
This abstract will not be presented at the 2012 ASCO Annual Meeting but has been published in conjunction with the meeting.
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J Clin Oncol 30, 2012 (suppl; abstr e18096)
Chiara Lazzari, Marcello Tiseo, Vanesa Gregorc, Fiorenza Latteri, Massimo Ippolito, Segio Balderi, Sebastiano Cosentino, Maura Scarlattei, Heinrich Roder, Julia Grigorieva, Joanna Roder, Roberto Bordonaro, Andrea Ardizzoni, Luca Gianni, Hector J. Soto Parra; Department of Oncology, Istituto Scientifico San Raffaele, Milan, Italy; Unità di Oncologia Medica, Azienda Ospedaliero-Universitaria, Parma, Italy; Medical Oncology, Garibaldi Hospital, Catania, Italy; Nuclear Medicine, Cannizzaro Hospital, Catania, Italy; Nuclear Medicine, University Hospital of Parma, Parma, Italy; Biodesix Inc., Broomfield, CO; Oncology Unit - Garibaldi Hospital, Catania, Italy; Unità di Oncologia Medica, Azienda Ospedaliero-Universitaria, Parma, Italy; Istituto Scientifico San Raffaele, Milan, Italy; Medical Oncology, University Hospital Policlinico - Vittorio Emanuele, Catania, Italy

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Abstract Disclosures


Background: Matrix Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI TOF MS) was used to create and validate a plasma proteomic algorithm VeriStrat (VS), based on 8 m/z peaks, and able to select advanced NSCLC pts who may benefit from EGFR TKIs. The algorithm was associated with PFS and OS of patients treated with EGFR TKIs and not with chemotherapy. Standardized Uptake Value (SUV) is of prognostic value for survival in non-small cell lung cancer. Aim of the current study was to analyze the OS and TTP in advanced NSCLC pts treated with erlotinib (E) according to baseline VeriStrat classification and baseline SUVs of FDG-PET. Methods: Plasma samples were collected before the beginning of E from metastatic NSCLC patients. Acquired spectra were classified according to the VeriStrat algorithm. The FDG-PET was performed the day before the beginning of E. Results: Thirty eight NSCLC pts on E therapy with the following characteristics were analyzed: median age 62 years old, 63% were males, 53% had adenocarcinoma histology, response rate was 26%, median OS 10 mos and (TTP) 3.4 mos. Twenty-six (68%) were classified as VS Good, 12 (32%) as Poor. TTP and OS for VS Good and Poor were 4.1 vs 2.1 mos (HR 0.86, log-rank p=0.6) and 11.1 vs 4.1 mos (HR 0.45,log-rank p=0.02), respectively. Baseline SUV levels were associated with TTP (Wilcoxon test p=0.001) but not with OS (all pts progressed, 5 still alive). All Poor classified pts had SUV ≥ 7 and had the worst TTP and OS; VS Good classified patients had worse TTP and OS if their baseline SUV level was > 7 than those who were VS Good and had SUV<7(see Table: 3-curves comparison log-rank test p value for a trend). Conclusions: We confirmed that pts with VS Poor classification have significantly shorter OS than those classified as VS Good. Pts with VS Good profile and with low baseline SUV levels may benefit more from EGFR TKI than VS Good pts with high SUV.