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VeriStrat: a prognostic and/or predictive biomarker for advanced lung cancer patients?

The role of EGF receptor (EGFR) inhibitors in the treatment of lung cancer without activating EGFR mutations has been a controversial issue, particularly their relative efficacy over the available chemotherapy in the second- and third-line setting. VeriStrat is a serum/plasma proteomic test developed using matrix-assisted laser desorption/ionization methodology, aiming at predicting benefit from EGFR treatment. The VeriStrat algorithm has been interrogated retrospectively and prospectively in samples from randomised trials, such as the PROSE study, confirming the prognostic information associated with the signature. In addition, the test appeared to be predictive of erlotinib impact on survival, as only VeriStrat Good patients benefited from such a treatment. Additional studies should confirm and further define its role in predicting EGFR tyrosine kinase inhibitor benefit, and to establish its better use in terms of clinical efficiency identifying which patients are candidates for the test, at which time on the history of the disease, and lastly at what extra cost.