Site Editor
Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Tuesday, May 28, 2024
Researchers may have created a more precise way of assessing which first-line treatment may offer the best possible result for a given patient with non–oncogene-driven metastatic non–small cell lung cancer (NSCLC). The treatment-personalization method, developed by David R. Gandara, MD, of the University of California Davis Comprehensive Cancer Center, Sacramento, and colleagues, is based on PROphet, a plasma proteomic–based machine learning test performed using SomaScan Assay v4.1. These findings were published in JCO Precision Oncology.
According to the investigators, the current standard treatment-decision approach “fails to account for individual patient variability and [for] host immune factors.” In contrast, “PROphet assists in identifying those patients with PD-L1–low and PD-L1–negative tumors who may benefit most from PD-1/PD-L1 inhibitor–based therapy and those who are expected to have little or no significant benefit, who could consider other options including a clinical trial,” they explained. “In the PD-L1–high subgroup (≥ 50%), [the] data support [PROphet’s] role in distinguishing those best approached with monotherapy vs combination with chemotherapy.”
Patients are categorized (using the results of a simple blood test) as either PROphet-positive or PROphet-negative and then further stratified by PD-L1 expression. This multicenter observational trial included 540 patients undergoing PD-1/PD-L1 inhibitor–based therapy (either alone or with chemotherapy) and an additional 85 patients receiving chemotherapy alone.
The investigators could successfully differentiate between outcomes experienced by PROphet-negative patients with tumor PD-L1 levels ≥ 50%, the trial data showed. “These patients had enhanced overall survival when treated with a combination of immunotherapy and chemotherapy compared with immunotherapy alone (P = .0003),” they wrote. In contrast, PROphet-positive patients with similarly high PD-L1 levels showed comparable outcomes whether they were treated with immunotherapy alone or in combination with chemotherapy (P = .424).
“Further studies will prospectively evaluate PROphet in additional populations, other clinical settings, and across various stages and tumor types,” the study authors concluded.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
JNCCN Spotlights
