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Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2019 ASCO Annual Meeting but not presented at the Meeting, can be found online only.

Correlating the effects of VeriStrat result, anti-PD1 therapy, and neutrophil-to-lymphocyte ratio (NLR) on progression-free survival (PFS) in patients with stage IV non-small cell lung cancer (NSCLC).

Metastatic Non-Small Cell Lung Cancer

Lung Cancer—Non-Small Cell Metastatic

2019 ASCO Annual Meeting

Abstract No:

J Clin Oncol 37, 2019 (suppl; abstr e20660)

Author(s): Megan Randall, Sanjib Basu, Marta Batus, Jeffrey Allen Borgia, Philip D. Bonomi, Mary J. Fidler; Rush University Medical Center, Chicago, IL

Abstract Disclosures


Background: Biodesix VeriStrat (VS) is a mass spectrometry assay found to be prognostic in previously treated and front-line NSCLC patients. A label assigns a “good” or “poor” result and is believed to in part represent host inflammatory reaction to tumor. This study looks to correlate VS good (VS-G) or poor (VS-P) label with the neutrophil to lymphocyte ratio (NLR) and outcomes in front-line NSCLC patients who were screened for actionable mutations as part of a companion diagnostic. Methods: Retrospective chart review was conducted of 76 patients with advanced NSCLC who had pretreatment VS testing. Included patients had at least 3-month follow up. Chi squared analysis was used to correlate VS label with patient characteristics and Cox proportional hazards was used to correlate PFS with VS label, NLR and other baseline characteristics in patients receiving anti-PD1 targeted therapy as part of their first treatment. Results: Median PFS was 6.31 months (follow up range 3-17 months). Of 76 tested patients, 23 never received treatment and 47 received anti-PD1 therapy. 51 had VS-G and 23 had VS-P (2 indeterminate). Using two standard NLR cutoffs of 3.5 and 5, 29 and 47, and 42 and 34 had values above and below the cutoff, respectively. VS-G vs VS-P correlated with performance status (PS) as well as NLR at both cut points and on a continuous scale. (P = 0.031, 0.043, 0.045, and 0.056 respectively, VS-G correlating with good PS and low NLR). There was no correlation with PDL1 or body mass index. On multivariate analysis VS label and NLR were also associated with PFS and OS (P = < 0.001 and P = 0.046). Among a subset of 47 patients treated with ICIs, VS-G and NLR < 5 were associated with longer PFS (P = 0.010 and 0.010) though PDL1 result was not. Conclusions: This is the first description of the performance of the VS mass spectrometry assay in front-line patients whose regimen included an anti-PD1 agent. The VS label was able to predict for PFS in this patient population despite relatively short follow up. VS-G label also correlated with low NLR by multiple methods analyzed. Further evaluation of the impact of cytotoxic chemotherapy to anti-PD1 is warranted.

Other Abstracts in this Sub-Category:


1. Association of STK11/LKB1 genomic alterations with lack of benefit from the addition of pembrolizumab to platinum doublet chemotherapy in non-squamous non-small cell lung cancer.

Meeting: 2019 ASCO Annual Meeting Abstract No: 102 First Author: Ferdinandos Skoulidis
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer


2. Real-world outcomes of patients with advanced non-small cell lung cancer (aNSCLC) and autoimmune disease (AD) receiving immune checkpoint inhibitors (ICIs).

Meeting: 2019 ASCO Annual Meeting Abstract No: 110 First Author: Sean Khozin
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer


3. RELAY: A multinational, double-blind, randomized Phase 3 study of erlotinib (ERL) in combination with ramucirumab (RAM) or placebo (PL) in previously untreated patients with epidermal growth factor receptor mutation-positive (EGFRm) metastatic non-small cell lung cancer (NSCLC).

Meeting: 2019 ASCO Annual Meeting Abstract No: 9000 First Author: Kazuhiko Nakagawa
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer