251PD - European inter-institutional impact study of mammaprint

Date 29 September 2012
Event ESMO Congress 2012
Session Breast cancer, early stage
Topics Breast Cancer, Early Stage
Diagnostics
Presenter Pino Cusumano
Authors P. Cusumano1, D.G. Generali2, E. Ciruelos3, L. Manso3, I. Ghanem3, E. Lifrange4, G. Jerusalem4, J. Klaase5, L. Stork-Sloots6, M. Lutke Holzik7
  • 1Surgical Oncology, CHU Sart Tilman, 4000 - Liege/BE
  • 2Unità Di Patologia Mammaria - Breast Unit, Istituti Ospitalieri di Cremona, IT-26100 - Cremona/IT
  • 3Medical Oncology, Hopital 12 de Octubre, Madrid/ES
  • 4Hematology And Medical Oncology, University of Liege, CHU Sart Tilman, BE-4000 - Li/BE
  • 5Surgery, Medisch Spectrum Twente, Enschede, enschede/NL
  • 6Medical Affairs, Agendia NV, 1098 XH - Amsterdam/NL
  • 7Surgical Oncology, Saxenburgh groep Hardenberg, Hardenberg/NL

Abstract

Background

Medical board interpretation of prognostic and predictive factors and quality of IHC analysis can substantially affect the adjuvant treatment advice, resulting in substantial differences in treatment recommendations; with risk of potential over- and under treatment. Introduction of a centralized multi-gene assay could potentially lead to more formalized treatment recommendations throughout Europe. The primary aim of this study was to measure the impact of MammaPrint on chemotherapy treatment advice for patient cohorts from 3 different European institutes.

Methods

Between 2008 and 2010, tumor samples from early stage breast cancer patients (T1-3, N0-1, M0, < 70 years and MammaPrint assessed) were prospectively collected in 3 European hospitals: 92 patients from Belgium, 36 patients from Italy and 66 patients from the Netherlands. Blinded for the actual treatment advise, the clinical characteristics of the patients were sent to the multidisciplinary teams of the 3 contributing hospitals and a team of a fourth hospital and treatment advise was assessed. Subsequently, MammaPrint results were disclosed and treatment advice was assessed again. Discordance in treatment advise between the 4 multidisciplinary teams was determined and the impact of MammaPrint was measured.

Results

Treatment advice as assessed by the Spanish multidisciplinary team was changed in 27% of patients after disclosure of MammaPrint results, in 33% of patients as assessed by the Dutch team, in 26% of patients by the Italian team and in 22% of patients by the Belgian team. The inter-institutional agreement for the four multidisciplinary teams in treatment advice was 57% (prior to MammaPrint disclosure) and increased to 79% after disclosing MammaPrint results.

Conclusion

This study demonstrates high variability in adjuvant chemotherapy treatment advice between multidisciplinary teams from 4 different European hospitals based on traditional patient and tumor related parameters. MammaPrint would have modified adjuvant chemotherapy treatment advice in around 27% of patients and lead to a more consistent and objective treatment advice.

Disclosure

L. Stork-Sloots: I am an employee of Agendia.

All other authors have declared no conflicts of interest.