14P - Adoption of multi-gene assays in HR+, HER2– breast cancer (BC) patients in Europe: results of the Multidisciplinary Application of Genomics in Cli...

Date 08 May 2014
Event IMPAKT 2014
Session Welcome reception and Poster Walk
Topics Breast Cancer
Personalised Medicine
Presenter Matti Aapro
Citation Annals of Oncology (2014) 25 (suppl_1): i5-i7. 10.1093/annonc/mdu065
Authors M.S. Aapro1, M. De Laurentiis2, E. Mamounas3, M. Martin4, D. Rea5, R. Rouzier6, V. Smit7, C. Thomssen8
  • 1Multidisciplinary Oncology Institute, Clinique de Genolier, 1272 - Genolier/CH
  • 2Department Of Senology, National Cancer Institute G. Pascale Foundation, Naples/IT
  • 3Department Of Surgical Oncology, MD Anderson Cancer Center Orlando, Orlando/US
  • 4Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Madrid/ES
  • 5Queen Elizabeth Hospital, University of Birmingham, Birmingham/UK
  • 6Department Of Surgery, Institute Curie, Paris/FR
  • 7Department Of Pathology, Leiden University Medical Center, Leiden/NL
  • 8Department Of Gynecology, Martin-Luther-University Halle-Wittenberg,, Halle (Saale)/DE



Multi-gene assays (MGA) have been demonstrated to provide prognostic and predictive information beyond traditional parameters. The MAGIC survey aimed to identify criteria used regarding BC adjuvant chemotherapy (ACT) need, and to characterize patients (pts) for whom available data are sufficient for a decision and those for whom more data are required for informed decision-making. The survey also assessed MGA adoption, MGA usage in practice, and reasons for not using MGA.

Material and methods:

From August 2013 to January 2014 an online survey was made available for physicians with ≥5 years of experience in treating BC. Country specific trends were evaluated for smaller countries (pop. <25 million) with 25 responses and for larger countries (pop. >25 million with at least 50 responses).


643 eligible respondents from 34 European countries completed the survey; ∼75% had >10 years of experience in BC diagnosis/treatment. Eleven countries had a sufficient number of responses to evaluate country specific trends (BE, CH, FR, DE, GR, HU, IT, NL, ES, SW, and UK). Overall, 51% of respondents use a MGA in their clinical practice. There was a wide range of usage from ≤20% (IT and SW) to ≥80% (DE, GR, and NL). Of those who use a MGA, 68% use it in <20% of their HR +, HER2– LN-neg BC pts. The specific MGA they use are: Prosigna(1%) FEMTELLE® (2%) EndoPredict® (5%), MammaPrint® (15%), Oncotype DX® Breast Cancer Assay (39%) and other (5%). By country, MammaPrint is used most in NL and ES, and Oncotype DX is used most elsewhere except SW where no MGA is used. Of those who do not use a MGA, 85% would like to incorporate MGA in their practice, but report lack of reimbursement (51%), price (41%), no availability (35%), not in relevant guidelines (20%), and lack of evidence (19%) as reasons for no use.


There is substantial heterogeneity in the adoption of MGA in Europe. A majority of physicians indicate they would use MGA in clinical practice in a subset of HR +, HER2-negative BC. The main perceived barriers to usage are reimbursement, price, and lack of availability. This study was supported by an unrestricted grant from Genomic Health Inc.


M.S. Aapro: Advisory board for Genomic Health Inc. Corporate-sponsored research from CarisLifeSciences and Champions Other substantive relationships NGS Agora

. M. De Laurentiis: Advisory board for Genomic Health Inc.

E. Mamounas: Advisory board for Genomic Health Inc. and GE Healthcare Speakers' bureau for Genomic Health Inc.

M. Martin: Speakers' honoraria from Genomic Health Inc.

D. Rea: Advisory board for Genomic Health Inc.

R. Rouzier: Advisory board for Genomic Health Inc., Roche and GSK Corporate-sponsored research from Roche and GSK.

V. Smit: Advisory board for Genomic Health Inc.

C. Thomssen: Advisory board for Genomic Health Inc. Research support from American Diagnostica.