ASCO 2013 Video: Can we predict response to Tarceva based on a blood test?

Portal Forums Lung/Thoracic Cancer General Lung/Thoracic Cancer ASCO 2013 Video: Can we predict response to Tarceva based on a blood test?

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June 12, 2013 at 6:26 am  #1257204    
JimC Forum Moderator
JimC Forum Moderator

There is a new video from the ASCO round table with Drs. Pennell, Pinder and West in which they review results from the PROSE trial presented at ASCO 2013, testing the predictive value of the Veristrat test of serum proteomics to assess the potential value of erlotinib (Tarceva) in advanced NSCLC. You can find the video here: http://cancergrace.org/lung/2013/06/12/prose-trial-veristrat/

We welcome your questions and comments here.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

July 1, 2013 at 3:08 pm  #1257659    

texandave

Dear JimC and Grace Staff,

We know that insurance companies have a reputation for not playing fair, but I want you to know that I have just had a phone contact with a rep from Biodesix, who makes the Versitrat Test. He told me that BlueCrossBlueShield of Texas denies coverage of Veristrat, calling the test “obscure”. We do not have to bother Drs. West, Pennell or Pinder on this matter unless they are wanting to chime in – as this is just shamefully ignorant or dripping with fanatical denial of powerful information. How can these people making and enforcing these answers go home and digest their dinner with a clear conscience?

Texandave

Stage IV lung adenocarcinoma diagnosed in nonsmoker who worked in labs with ethydium bromide, benzene and toluene which were questionably vented for a couple of years. No family history of lung cancer. Thankfully NED for several months; been on Tarceva since March 2012. Ready to create patient/caregiver EGFR+ thread.

July 1, 2013 at 3:33 pm  #1257661    
Dr West
Dr West

Texandave,

I don’t mean to be an apologist or defender of any insurer, but I think that the Biodesix test doesn’t really answer a question I consider to be that helpful. It essentially asks “should I not even bother with an EGFR tyrosine kinase inhibitor like Tarceva?” It doesn’t say that doing Tarceva (erlotinib) is a better idea than chemo, and it essentially can only say it’s a worse idea than second line chemo in some patients. There’s now a growing amount of evidence to say that it’s arguably best to give chemo over Tarceva as second line therapy to anyone who doesn’t have an activating EGFR mutation, so if you follow that strategy, the only clear value of the Veristrat test is to say whether Tarceva isn’t even worth trying later. If you’re going to decide to not even take Tarceva if the Veristrat test comes back as poor, I think the test makes sense. But most of my patients aren’t eager to eliminate an FDA approved option that might help and will almost always be covered as a third line agent for NSCLC, so I don’t see how Veristrat provides an actionable answer to any question I’d commonly ask in my clinic patients.

-Dr. West

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