The value of proteomics in lung cancer

Many studies have identified the prognostic and predictive value of proteins or peptides in lung cancer but most failed to provide strong evidence for their clinical applicability. The strongest predictive proteins seem to be fatty acid-binding protein heart (H-FABP), and the 8-peak mass spectrography signature of VeriStrat. When focusing on VeriStrat, a ‘VeriStrat good’ profile did not discriminate between chemotherapy and erlotinib. The ‘VeriStrat poor’ profile showed a better outcome to chemotherapy than to erlotinib. VeriStrat is a prognostic test and only the “poor profile” discriminates for the type of therapy that should be chosen. Whether it adds useful information in patients with advanced non-small cell lung cancer (NSCLC) and wildtype EGFR mutations is still doubtful. The position of the VeriStrat test in clinical practice is still not clear and we are waiting for prospective studies where biomarker test are involved in clinical decision.