A recently published study has demonstrated the objective prognostic value of the VeriStrat test by Biodesix, Boulder, Colo, for patients with non-small cell lung cancer (NSCLC).1

Researchers at the University of Torino utilized samples from the Phase 3 Marquee trial and found that the VeriStrat test was a significant predictor of patient outcomes, independent of Eastern Cooperative Oncology Group (ECOG) performance status, patient epidermal growth factor receptor (EGFR) mutation status, treatment received, and other clinical variables.

“The present data confirm that VeriStrat results provide information that can impact treatment decisions for both EGFR mutated and non-mutated patient populations,” says Giorgio V. Scagliotti, MD, PhD, principal investigator of the study, former head of the department of oncology at the University of Torino, and now chief of the medical oncology division at San Luigi Hospital. “Additionally, VeriStrat results can be combined with performance status to create a stronger prognostic indicator for forming treatment strategies. While further validation studies are needed, this data adds to the growing body of evidence supporting the utility of VeriStrat results in patients with NSCLC.”


Linda Traylor, PhD, Biodesix.

The study of 1,048 patients demonstrated that patients with VeriStrat poor results and a better ECOG performance status (PS 0) have worse overall survival compared to VeriStrat good patients with a worse ECOG performance status (PS 1). Additionally, VeriStrat results are applicable to predicting response differences in EGFR mutation-positive patients as well as those that are EGFR wild-type.

In the EGFR mutation-positive subgroup, patients with a VeriStrat good result experienced improved overall survival as compared to patients with a VeriStrat poor result when treated with a single-agent EGFR-tyrosine kinase inhibitor (EGFR-TKI). When the combination of two EGFR-TKI therapies was used, patients with VeriStrat good results still outperformed those with VeriStrat poor results, but those with VeriStrat poor results performed better on the combination therapy than on erlotinib alone, suggesting the need for an alternative treatment strategy, which could include novel combination therapies. By contrast, patients with a VeriStrat good result did not receive significant benefit from the additional agent.

“This analysis provides further evidence that VeriStrat testing can enhance the prognostic evaluation of patients with advanced NSCLC and guide patients and physicians in making effective treatment decisions,” says Linda Traylor, PhD, vice president for clinical development and medical affairs at Biodesix. “The study also indicates VeriStrat testing may be used as an additional prognostic tool for EGFR-mutated patients. Results suggest that patients with an EGFR mutation and a VeriStrat poor result may benefit from an alternative, potentially more aggressive treatment strategy. This is the second published study to indicate that TKI combination therapy may salvage patients with a VeriStrat poor result. Further research in this patient population is a high priority for Biodesix.”

VeriStrat is a multivariate, mass-spectrometry based test that measures circulating proteins in the blood serum or plasma of patients with NSCLC. Test results assign a VeriStrat good or VeriStrat poor classification to patient samples. Multiple studies support the observation that patients with a VeriStrat good result have a better prognosis than patients with a VeriStrat poor result, independent of current clinical prognostic indicators and treatment choice.

For further information, visit Biodesix.


  1. Buttigliero C, Shepherd FA, Barlesi F, et al. Retrospective assessment of a serum proteomic test in a phase III study comparing erlotinib plus placebo with erlotinib plus tivantinib (Marquee) in previously treated patients with advanced non-small cell lung cancer. Oncologist. Epub ahead of print, August 23, 2018; doi: 10.1634/theoncologist.2018-0089.

Featured image: The Biodesix Lung Reflex blood sample collection kit for GeneStrat and VeriStrat testing.