Predictive value of a serum-based proteomic test in non-small-cell lung cancer patients treated with epidermal growth factor receptor tyrosine kinase inhibitors: a meta-analysis

Objective: Several studies have demonstrated that a serum-based proteomic test (VeriStrat*) is able to predict the clinical outcome of non-small-cell lung cancer (NSCLC) patients treated with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). However, these studies have limited power to draw a precise conclusion because of their small sample sizes and inconsistent results. Therefore, a metaanalysis was carried out in an attempt to provide more persuasive evidence. Research design and methods: Electronic searches for relevant articles in PubMed, Embase, Medline, and Web of Science published up to May 2013 were conducted. Stata Statistical Software version 12.0 was applied for statistical analysis. The combined hazard ratio (HR) and 95% confidence interval (CI) were estimated using fixed-effects models. Results: Eleven cohorts involving 706 patients collected from seven studies were subjected to final analysis. This serum-based proteomic test's 'good' status predicted a better clinical outcome with a pooled HR of 0.40 (95% CI 0.32 to 0.49; p<0.001) for overall survival (OS), and 0.49 (95% CI 0.39 to 0.60; p<0.001) for progression-free survival (PFS). There was no significant heterogeneity, but a slight publication bias in this study. Conclusions: Our meta-analysis demonstrated that this serum-based proteomic test has a predictive value for NSCLC patients treated with EGFR-TKIs. Future data are needed to validate and update our results.