New marker/predictor(ICAM) of chemo efficacy for lung cancer(ASCO 2006)
 

If & when ICAM is adopted in practice, it may help avoid chemo that is not likely to help patients with NSCLC

http://www.docguide.com/news/content...25718800471E9B
Title: Researchers Find Biomarker of Response to Chemotherapy in Non-Small-Cell Lung Cancer: Presented at ASCO
By Paula Moyer ATLANTA, G.A. -- June 8, 2006 -- Patients with non-small-cell lung cancer (NSCLC) who have lower baseline levels of soluble intercellular adhesion molecule-1 (ICAM) are more likely to respond to chemotherapy and to have longer progression-free survival, according to findings presented here at the American Society of Clinical Oncology 2006 Annual Meeting (ASCO). "Baseline plasma ICAM is strongly prognostic for survival in advanced NSCLC," said principal investigator Afshin Dowlati, MD, consultant hematologist/oncologist, the Ireland Cancer Center, and assistant professor of medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio. "This biomarker is strongly prognostic for response to chemotherapy." In a presentation on June 5[th, Dr. Dowlati presented the results of a study, conducted to determine whether adding bevacizumab to chemotherapy regimen that combines carboplatin and paclitaxel would improve progression-free survival in NSCLC. The researchers measured patients' levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), soluble ICAM, and e-selectin at pretreatment and at week 7.

Dr. Dowlati presented data available for 166 patients at the pre-treatment time point and 112 at post-treatment. Measurements above and below the median for each biomarker were defined as low and high, respectively.

The investigators identified significant associations between e-selectin and ICAM (P =.003). Similarly they found associations between bFGF and VEGF (P =.01). E-selectin and bFGF decreased significantly from baseline to week 7 in both patients that did and did not use bevacizumab (P =.01 for bFGF, respectively).

However, only baseline ICAM showed a significant association with response to treatment. Among patients with low baseline ICAM, 29% in both arms responded to treatment, compared to 13% of those with high ICAM levels (P =.03,). Among patients with low baseline ICAM levels, 65% were alive 1 year after treatment, compared to 25% of those with high levels (P =.00005).

"No other factor predicted survival," Dr. Dowlati said. "Tests for treatment by factor interactions were significant only for baseline ICAM."

Among patients with low baseline levels, progression-free survival was significantly longer in those treated with bevacizumab (P =.04). However, the addition of bevacizumab made no difference among patients with high baseline ICAM.

Therefore, Dr. Dowlati and his co-investigators concluded that adding bevacizumab primarily benefited only patients with low baseline ICAM levels.


[Presentation title: Prospective Correlative Assessment of Biomarkers in E4599 Randomized Phase II/III Trial of Carboplatin and Paclitaxel ± Bevacizumab in Advanced Non-Small Cell Lung Cancer (NSCLC). Abstract 7027]