1
|
Tanvetyanon T, Creelan BC, Chiappori AA. Current clinical application of genomic and proteomic profiling in non-small-cell lung cancer. Cancer Control 2014; 21:32-9. [PMID: 24357739 DOI: 10.1177/107327481402100105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Genomic or proteomic profiling of cancer can be broadly defined as a systematic grouping of cancer based on its genetic or protein makeup. In the management of non-small-cell lung cancer (NSCLC), genomic and proteomic profiling applications have become useful in early disease detection, diagnosis, treatment, and prognostication. METHODS We reviewed the recent literature on the applications of genomic and proteomic profiling in NSCLC. Important applications were summarized into those already adopted as standard care and those still under investigation. RESULTS For genomic profiling, testing for EGFR mutation and ALK rearrangement has become routine for adenocarcinoma. Multiplex assay and malignancy-risk gene signature are both important applications in development. A test to predict outcome after treatment with an epidermal growth factor rector/tyrosine kinase inhibitor and a screening blood test for lung cancer are being investigated for use in proteomic profiling. CONCLUSIONS Genomic profiling is routine in patients with NSCLC, and proteomic profiling shows promise. Additional genomic and proteomic profiling applications may also prove to be useful contributions in the care of these patients.
Collapse
Affiliation(s)
- Tawee Tanvetyanon
- Thoracic Oncology Program, Moffitt Cancer Center, Tampa FL 33612, USA.
| | | | | |
Collapse
|
2
|
Rozensztajn N, Ruppert AM, Lavole A, Leprieur EG, Duruisseaux M, Vieira T, Rabbe N, Lacave R, Antoine M, Cadranel J, Wislez M. Factors associated with early progression of non-small-cell lung cancer treated by epidermal growth factor receptor tyrosine-kinase inhibitors. Cancer Med 2014; 3:61-9. [PMID: 24408092 PMCID: PMC3930390 DOI: 10.1002/cam4.180] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 10/19/2013] [Accepted: 11/20/2013] [Indexed: 12/30/2022] Open
Abstract
Epidermal growth factor receptor tyrosine-kinase inhibitors (EGFR-TKI) are a therapeutic option as second-line therapy in non-small-cell lung carcinoma (NSCLC), regardless of the EGFR gene status. Identifying patients with early progression during EGFR-TKI treatment will help clinicians to choose the best regimen, TKI or chemotherapy. From a prospective database, all patients treated with gefitinib or erlotinib between 2001 and 2010 were retrospectively reviewed. Patients were classified into two groups according to their tumor response by RECIST after 45 days of treatment, progressive disease (PD) or controlled disease (CD). Two hundred and sixty-eight patients were treated with EGFR-TKI, among whom 239 were classified as PD (n = 75) and CD (n = 164). Median overall survival was 77 days (95% CI 61-109) for PD and 385 days (95% CI 267-481) for CD. Patients with PD were of younger age (P = 0.004) and more frequently current smokers (P = 0.001) had more frequently a performance status ≥2 (P = 0.012), a weight loss ≥10% (P = 0.025), a shorter time since diagnosis (P < 0.0001), a pathological classification as non-otherwise-specified NSCLC (P = 0.01), and the presence of abdominal metastases (P = 0.008). In multivariate analysis, abdominal metastases were the only factor associated with early progression (odds ratio (OR) 2.17, 95% CI [1.12-4.19]; P = 0.021). Wild-type EGFR versus mutated EGFR was associated with early progression. The presence of abdominal metastasis was independently associated with early progression in metastatic NSCLC receiving EGFR-TKI.
Collapse
Affiliation(s)
- Nathalie Rozensztajn
- Service de Pneumologie, Hôpital TenonAP-HP, 4 rue de la Chine, Paris, 75970, France
| | - Anne-Marie Ruppert
- Service de Pneumologie, Hôpital TenonAP-HP, 4 rue de la Chine, Paris, 75970, France
- Equipe de Recherche2/GRC-UPMC04 Theranoscan, Université Pierre et Marie Curie Paris 6, Hôpital Tenon4 rue de la Chine, Paris, France
| | - Armelle Lavole
- Service de Pneumologie, Hôpital TenonAP-HP, 4 rue de la Chine, Paris, 75970, France
| | - Etienne Giroux Leprieur
- Equipe de Recherche2/GRC-UPMC04 Theranoscan, Université Pierre et Marie Curie Paris 6, Hôpital Tenon4 rue de la Chine, Paris, France
| | - Michael Duruisseaux
- Equipe de Recherche2/GRC-UPMC04 Theranoscan, Université Pierre et Marie Curie Paris 6, Hôpital Tenon4 rue de la Chine, Paris, France
| | - Thibault Vieira
- Equipe de Recherche2/GRC-UPMC04 Theranoscan, Université Pierre et Marie Curie Paris 6, Hôpital Tenon4 rue de la Chine, Paris, France
| | - Nathalie Rabbe
- Service de Pneumologie, Hôpital TenonAP-HP, 4 rue de la Chine, Paris, 75970, France
- Equipe de Recherche2/GRC-UPMC04 Theranoscan, Université Pierre et Marie Curie Paris 6, Hôpital Tenon4 rue de la Chine, Paris, France
| | - Roger Lacave
- Plateforme de Biologie moléculaire, Service de Cytologie et Biologie Tumorale, Hôpital TenonAP-HP, 4 rue de la Chine, Paris, 75970, France
| | - Martine Antoine
- Equipe de Recherche2/GRC-UPMC04 Theranoscan, Université Pierre et Marie Curie Paris 6, Hôpital Tenon4 rue de la Chine, Paris, France
- Service d'Anatomie Pathologique, Hôpital TenonAP-HP, 4 rue de la Chine, Paris, 75970, France
| | - Jacques Cadranel
- Service de Pneumologie, Hôpital TenonAP-HP, 4 rue de la Chine, Paris, 75970, France
- Equipe de Recherche2/GRC-UPMC04 Theranoscan, Université Pierre et Marie Curie Paris 6, Hôpital Tenon4 rue de la Chine, Paris, France
| | - Marie Wislez
- Service de Pneumologie, Hôpital TenonAP-HP, 4 rue de la Chine, Paris, 75970, France
- Equipe de Recherche2/GRC-UPMC04 Theranoscan, Université Pierre et Marie Curie Paris 6, Hôpital Tenon4 rue de la Chine, Paris, France
| |
Collapse
|
3
|
A retrospective analysis of VeriStrat status on outcome of a randomized phase II trial of first-line therapy with gemcitabine, erlotinib, or the combination in elderly patients (age 70 years or older) with stage IIIB/IV non-small-cell lung cancer. J Thorac Oncol 2013; 8:443-51. [PMID: 23370367 DOI: 10.1097/jto.0b013e3182835577] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE In a multicenter randomized phase II trial of gemcitabine (arm A), erlotinib (arm B), and gemcitabine and erlotinib (arm C), similar progression-free survival (PFS) and overall survival (OS) were observed in all arms. We performed an exploratory, blinded, retrospective analysis of plasma or serum samples collected as part of the trial to investigate the ability of VeriStrat (VS) to predict treatment outcomes. METHODS Ninety-eight patients were assessable, and the majority had stage IV disease (81%), adenocarcinoma histology (63%), reported current or previous tobacco use (84%), and 26% had a performance status (PS) of 2. RESULTS In arm A, patients with VS Good (n = 20) compared with VS Poor status (n = 8) had similar PFS (hazard ratio [HR]: 1.21; p = 0.67) and OS (HR: 0.82; p = 0.64). In arm B, patients with VS Good (n = 26) compared with VS Poor (n = 12) had a statistically significantly superior PFS (HR: 0.33; p = 0.002) and OS (HR: 0.40; p = 0.014). In arm C, patients with VS Good (n = 17) compared with Poor (n = 1 5) had a superior PFS (HR: 0.42; p = 0.027) and a trend toward superior OS (HR: 0.48; p = 0.051). In the multivariate analysis for PFS, VS status was statistically significant (p = 0.011); for OS, VS status (p = 0.017) and PS (p = 0.005) were statistically significant. A statistically significant VS and treatment interaction (gemcitabine versus erlotinib) was observed for PFS and OS. CONCLUSIONS Gemcitabine is the superior treatment for elderly patients with VS Poor status. First-line erlotinib for elderly patients with VS Good status may warrant further investigation.
Collapse
|
5
|
Kuiper JL, Lind JSW, Groen HJM, Roder J, Grigorieva J, Roder H, Dingemans AMC, Smit EF. VeriStrat(®) has prognostic value in advanced stage NSCLC patients treated with erlotinib and sorafenib. Br J Cancer 2012; 107:1820-5. [PMID: 23079575 PMCID: PMC3505013 DOI: 10.1038/bjc.2012.470] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: The serum proteomic test VeriStrat has been shown to be able to classify advanced
non-small cell lung cancer (NSCLC) patients for overall survival (OS) after treatment
with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). In this
study, VeriStrat was evaluated as a pre-treatment stratification tool in patients with
advanced stage NSCLC for treatment with the combination of erlotinib and sorafenib,
considering both OS and progression-free survival (PFS) as end points. Methods: Serum samples from 50 patients treated within the context of a phase II trial of
first-line erlotinib and sorafenib were analysed with VeriStrat, a fully locked mass
spectrometry-based test that identifies patients likely to have good or poor outcome on
EGFR therapy based on eight distinct features in mass spectra. Analysis was performed
fully blinded to all clinical data, and then the outcome data were analysed with respect
to the obtained serum classifications. Results: VeriStrat classified pre-treatment samples into two groups, VeriStrat Good and
VeriStrat Poor, which were significantly different in OS (hazard ratio (HR) 0.30,
log-rank P=0.009) and in PFS (HR 0.40, log-rank
P=0.035). Conclusion: VeriStrat has shown its potential for stratification of unselected, advanced stage
NSCLC patients treated in first line with a combination of erlotinib and sorafenib.
Collapse
Affiliation(s)
- J L Kuiper
- Department of Pulmonary Diseases, VU University Medical Center, P.O. Box 7057, Amsterdam 1007 MB, The Netherlands
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Wu K, House L, Liu W, Cho WC. Personalized targeted therapy for lung cancer. Int J Mol Sci 2012; 13:11471-11496. [PMID: 23109866 PMCID: PMC3472758 DOI: 10.3390/ijms130911471] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 09/05/2012] [Accepted: 09/07/2012] [Indexed: 01/06/2023] Open
Abstract
Lung cancer has long been recognized as an extremely heterogeneous disease, since its development is unique in every patient in terms of clinical characterizations, prognosis, response and tolerance to treatment. Personalized medicine refers to the use of markers to predict which patient will most likely benefit from a treatment. In lung cancer, the well-developed epidermal growth factor receptor (EGFR) and the newly emerging EML4-anaplastic lymphoma kinase (ALK) are important therapeutic targets. This review covers the basic mechanism of EGFR and EML4-ALK activation, the predictive biomarkers, the mechanism of resistance, and the current targeted tyrosine kinase inhibitors. The efficacy of EGFR and ALK targeted therapies will be discussed in this review by summarizing the prospective clinical trials, which were performed in biomarker-based selected patients. In addition, the revolutionary sequencing and systems strategies will also be included in this review since these technologies will provide a comprehensive understanding in the molecular characterization of cancer, allow better stratification of patients for the most appropriate targeted therapies, eventually resulting in a more promising personalized treatment. The relatively low incidence of EGFR and ALK in non-Asian patients and the lack of response in mutant patients limit the application of the therapies targeting EGFR or ALK. Nevertheless, it is foreseeable that the sequencing and systems strategies may offer a solution for those patients.
Collapse
Affiliation(s)
- Kehua Wu
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA; E-Mails: (K.W.); (L.H.)
| | - Larry House
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA; E-Mails: (K.W.); (L.H.)
| | - Wanqing Liu
- Department of Medicinal Chemistry and Molecular Pharmacology, College of Pharmacy, Purdue University, West Lafayette, IN 47907, USA; E-Mail:
| | - William C.S. Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China
| |
Collapse
|