Article and Video CATEGORIES

Cancer Journey

Search By

Dr. Jack West is a medical oncologist and thoracic oncology specialist who is the Founder and previously served as President & CEO, currently a member of the Board of Directors of the Global Resource for Advancing Cancer Education (GRACE)


Serum Test Being Launched to Test for Likelihood of Benefit from Oral EGFR Inhibitors
Howard (Jack) West, MD

About 18 months ago, I wrote a post about a new technique being developed that looks at the pattern of proteins in the blood of a patient in order to determine whether a patient is likely to do well or poorly after receiving an EGFR tyrosine kinase inhibitor like tarceva (erlotinib) or iressa (gefitinib) for advanced NSCLC. This work was the product of collaborative work among folks at Vanderbilt University, the University of Colorado, and a Colorado based company called Biodesix.

At the time that I wrote the original post, there was a general plan to bring this test to commercial use. Earlier today, I met with some of the folks at the company, who told me that this plan is now moving forward, with a plan to launch the test, now known as Veristrat, in early March. While they didn't have additional published or formally presented information to highlight, they told me that they have continued to do studies of the serum from patients from all over the world that has validated what their test is trying to do. Here's the idea:

A small blood sample from the patient is sent to the company. They do a proteomic analysis (described in my prior post on the subject) and provide a result within 72 hours, separating patients into a "Good" and a "Poor" group: about two thirds are classified as "Good", one third as "Poor". What this test predicts is how patients will do after receiving an oral EGFR inhibitor.

Their work indicates that this isn't just a marker of whether someone will do well or poorly in general, but specifically how they will do with an EGFR inhibitor, and that the people who are in the "Poor" category have a faster progression on an EGFR inhibitor than with a placebo, so it isn't just ineffective, but even harmful treatment. The benefit of the test is to identify patients who should not receive an EGFR inhibitor, rather than to say that someone is going to do particularly well with one. I think that this is certainly valuable information, but I wonder if many patients won't be that anxious to discard this potential treatment, even if they test in the "poor" category.

Still, for patients in the "poor" category, this information would save the cost of a likely ineffective therapy for them, with side effects that are difficult for some people, and the treatment may even be detrimental for them. Because these patients often have alternative choices like chemotherapy available, knowing ahead of time that an EGFR inhibitor would be especially unlikely to be helpful seems like a valuable piece of information to have. And even for the patients who we would consider likely to benefit from an EGFR inhibitor, such as a never-smoker or a woman with an adenocarcinoma NSCLC tumor, for whom we might consider giving an EGFR inhibitor very early, it could be helpful to have a test that can give you an answer within 3 days about whether that might be a mistake.

I'd welcome your thoughts about how interested you'd be in potentially eliminating a treatment that could be a source of hope, but also could be a waste of time, money, and even be harmful in a subset of patients.

Next Previous link

Previous PostNext Post

Related Content

Lung Cancer OncTalk 2023
At our live event, Lung Cancer OncTalk 2023, Dr. Yang, Das, and Dagogo-Jack discuss commonly used terms in treatment options for lung cancer, how oncologists determine the stage of lung cancer, and what that means for treatment, the importance of driver mutation in NSCLC treatment, the vast number of NSCLC trials, among other topics which involve lung cancer treatments. To watch the complete playlist click here.
Lung Cancer OncTalk 2023
At our live event, Lung Cancer OncTalk 2023, Dr. Jeff Yang, discusses different surgical procedures used to treat early-stage lung cancer and different approaches to removing cancerous tissue from the lung. 
Lung Cancer OncTalk 2023
At our live event, Lung Cancer OncTalk 2023, Dr. Millie Das, discusses different Studies and Trials for NSCLC. Dr. Das specializes in the treatment of thoracic malignancies. She sees and treats patients both at the Stanford Cancer Center and at the Palo Alto VA Hospital. She is the Chief of Oncology at the Palo Alto VA and is an active member of the VA National Lung Cancer Working Group and Lung Cancer Precision Oncology Program. Learn more about Dr. Das here.

Forum Discussions

Hi and welcome to Grace.  Wow, I don't know why you can't get in to see your doc but I'd find a way or find another doc who can walk you...

Hi Amber, Welcome to Grace.  I'm so sorry you're going through this scare.  It could be a recurrence.  It also is as likely to be the contrast creating a better view. ...

Hi Blaze,


As much as I hate to say it, Welcome back Blaze.  It sounds like you're otherwise feeling good and enjoying life which is a wonderful place to be. ...

Waiting for my appointment with oncologist this morning. Thank you for the response. It helps. <3

It sounds like you’re thinking of this in a very appropriate way. Specifically, it sounds like the growth of the nodule is rather modest, though keep in mind that the change...

Hi and welcome to GRACE.  I'm sorry your mom is having this difficulty.  An indwelling catheter is used when the pleura space continually fills and the catheter is always there to...

Recent Comments

 Hi arm2966, Welcome to…
By JanineT GRACE … on
Joanne indwelling catheters
By arm2966 on
Hi and welcome to Grace. …
By JanineT GRACE … on
Hi Amber, Welcome to Grace. …
By JanineT GRACE … on