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The scope of this registry study is to measure chemosensitivity as defined by pCR (primary endpoint), or endocrine sensitivity as defined by partial response (decrease in longest tumor diameter or residual cancer burden category 1 (RCB1), a primary endpoint for neo-adjuvant endocrine therapy and a secondary endpoint for neoadjuvant chemotherapy), metastasis-free survival and relapse-free survival(secondary endpoints) in molecular subgroups, determined by the established MammaPrint, BluePrint, Targetprint and Theraprint profiles in addition to possible novel expression profiles.
This will be a prospective observational, case-only study linking MammaPrint, BluePrint, TargetPrint, TheraPrint and possible additional profiles of interest to treatment response and Distant Metastases Free Survival (DMFS) and Relapse Free Survival (RFS). Only patients who receive neo-adjuvant therapy can participate.
For this project, approximately 50-70 institutions in the US will be invited to contribute clinical patient data from enrolled patients after a MammaPrint, TargetPrint, BluePrint and TheraPrint test has been successfully performed and the patient has started neo-adjuvant therapy.
Treatment is at the discretion of the physician, adhering to NCCN approved regimens or a recognized alternative.
The clinical data is to be entered online at 4 time points; amounting to four Case Report Forms (CRFs). Data will be collected on an ongoing basis, the first CRF must be completed within 6 weeks after the MammaPrint, BluePrint, TargetPrint, and TheraPrint result was provided. The second CRF should be completed 4 weeks after definitive surgery. CRF 3 and CRF4 will be completed 2-3 and 5 years after surgery.
It is expected that we will enroll around 1000 patients in 4 years.
OBJECTIVES
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| MammaPrint, BluePrint, neo-adj CT or HT | All patients receive the MammaPrint and BluePrint gene expression profile. Treatment at the discretion of the physician while adhering to NCCN guidelines. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MammaPrint 70-gene expression profile | Other |
| ||
| BluePrint 80 gene expression profile |
| Measure | Description | Time Frame |
|---|---|---|
| Chemosensitivity as defined by pCR | For neo-adjuvant chemotherapy patients the primary endpoint is pathological complete response (pCR) which is defined as the absence of invasive carcinoma in both the breast and axilla at microscopic examination of the resection specimen, regardless of the presence of carcinoma in situ. The response rate and corresponding confidence intervals will be presented as a proportion of all patients enrolled. Comparison of response rates between different molecular subgroups will be conducted using Pearson Chi-square test. | Up to 6 months |
| Endocrine sensitivity as defined by partial response (decrease in longest tumor diameter or residual cancer burden category 1 (RCB1) | The primary endpoint for patients with neo-adjuvant hormonal therapy is partial response which is defined as decrease in longest tumor diameter. The response rate and corresponding confidence intervals will be presented as a proportion of all patients enrolled. Comparison of response rates between different molecular subgroups will be conducted using Pearson Chi-square test. | Up to 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Correlate chemosensitivity (as defined by pCR) to TheraPrint Therapy Gene Assay results. | Correlation of chemosensitivity and endocrine sensitivity (as defined by pCR) to TheraPrint Therapy Gene Assay results will be determined using Pearson correlation and linear fit models. | Up to 6 months. |
| Assess metastasis-free survival and relapse-free survival in molecular subgroups, determined by the established MammaPrint, BluePrint, profiles. |
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Inclusion Criteria:
Exclusion Criteria:
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Women with histologically proven breast cancer, who have started or are scheduled to start neo-adjuvant chemotherapy therapy or neo-adjuvant hormone therapy.
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| Name | Affiliation | Role |
|---|---|---|
| Pat Whitworth, MD | Nashville Breast Center | Principal Investigator |
| Stephanie Akbari, MD | Reinsch Pierce Family Center for Breast Health | Principal Investigator |
| Mark Gittleman, MD | Breast Care Specialists | Principal Investigator |
| Peter Beitsch, MD | Dallas Surgical Group | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Arizona Center for Cancer Care | Glendale | Arizona | 85306 | United States | ||
| 21 Century Oncology |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36108259 | Derived | Whitworth PW, Beitsch PD, Murray MK, Richards PD, Mislowsky A, Dul CL, Pellicane JV, Baron PL, Rahman RL, Lee LA, Dupree BB, Kelemen PR, Ashikari AY, Budway RJ, Lopez-Penalver C, Dooley W, Wang S, Dauer P, Menicucci AR, Yoder EB, Finn C, Blumencranz LE, Audeh W. Genomic Classification of HER2-Positive Patients With 80-Gene and 70-Gene Signatures Identifies Diversity in Clinical Outcomes With HER2-Targeted Neoadjuvant Therapy. JCO Precis Oncol. 2022 Sep;6:e2200197. doi: 10.1200/PO.22.00197. | |
| 35476550 |
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As part of routine breast cancer treatment, the doctor will conduct a core needle biopsy and provide tissue from the tumor to Agendia for testing. After the diagnostic test(s) from the Agendia Breast Cancer Suite have been performed on the tumor specimen, there might be some remaining tissue left.
| Other |
|
Kaplan-Meier curves for DMFS will be calculated for the following eight subgroups
|
| At -2-3 years and 5 years after definitive surgery. |
| Compare local IHC and FISH results (if available) with TargetPrint results. | Correlation of TargetPrint ER, PR, and HER2 microarray readout with IHC/FISH assessment will be determined using Pearson correlation and linear fit models. Agreement measurements between binary microarray and IHC classifications will be based on 2-way contingency table analysis and include overall concordance, positive agreement defined as the number of samples classified positive by both IHC and TargetPrint divided by the number of positive samples using IHC, negative agreement and Cohen's Kappa coefficient score. | Baseline; before start of neo-adjuvant therapy. |
| Compare the three BluePrint molecular subgroups with IHC-based subtype classification. | Correlation of BluePrint molecular subgroup microarray readout with IHC-based subtype classification. | Baseline; before start of neo-adjuvant therapy. |
| Document impact of MammaPrint, TargetPrint and BluePrint result on treatment decision. | Review the impact of MammaPrint, TargetPrint, and BluePrint on physician treatment decisions. | Baseline; before start neo-adjuvant therapy. |
| Scottsdale |
| Arizona |
| 85251 |
| United States |
| Alta Bates Summit Comprehensive Cancer Center | Berkeley | California | 94705 | United States |
| Fresno Breast Surgery | Fresno | California | 93710 | United States |
| BreastLink | Long Beach | California | 90806 | United States |
| Long Beach Memorial Medical Center | Long Beach | California | 90806 | United States |
| Community Hospital of Monterey Peninsula | Monterey | California | 93940 | United States |
| Alta Bates | Oakland | California | 94609 | United States |
| Comprehensive Cancer Center - Palm Springs | Palm Springs | California | United States |
| Sutter Roseville Medical Center | Roseville | California | 95661 | United States |
| SHARP Memorial | San Diego | California | United States |
| Redwood Regional | Santa Rosa | California | United States |
| Wellness Oncology Hematology | West Hills | California | 91307 | United States |
| Wellness Oncology Hematology | West Hills | California | United States |
| Exempla Health St Joseph | Denver | Colorado | 80218 | United States |
| Greenwich Hospital | Greenwich | Connecticut | 06830 | United States |
| Stamford Hospital | Stamford | Connecticut | 06902 | United States |
| Halifax Health Center for Oncology | Daytona Beach | Florida | 32114 | United States |
| Florida Hospital Memorial Medical Center | Daytona Beach | Florida | 32117 | United States |
| 21st Century Oncology | Fort Myers | Florida | 33907 | United States |
| St. Vincent Healthcare | Jacksonville | Florida | 322004 | United States |
| The Breast Institute at JFK Medical Center | Lake Worth | Florida | 33461 | United States |
| Baptist Health South Florida | Miami | Florida | 33183 | United States |
| Lakes Research | Miami Lakes | Florida | 33014 | United States |
| Dekalb Medical | Decatur | Georgia | United States |
| Northeast Georgia Medical Center | Gainesville | Georgia | 30501 | United States |
| Center for Breast Care | Savannah | Georgia | 31404 | United States |
| Advanced Breast Care Specialists | Bloomingdale | Illinois | 60108 | United States |
| University Surgical Consultants | Elk Grove Village | Illinois | 60007 | United States |
| Advocate Lutheran General Hospital | Park Ridge | Illinois | 60068 | United States |
| Hematology/Oncology of The North Shore | Skokie | Illinois | 60076 | United States |
| Evansville Surgical Associates | Evansville | Indiana | 47710 | United States |
| Northern Indiana Cancer Research | South Bend | Indiana | 46601 | United States |
| Willis-Knighton Cancer Center | Shreveport | Louisiana | 71103 | United States |
| Signature Breast Care | Lanham | Maryland | 20706 | United States |
| McLaren Health Care | Burton | Michigan | 48509 | United States |
| Great Lakes Cancer Management Specialists | Grosse Pointe Woods | Michigan | 48236 | United States |
| Providence Cancer Institute | Southfield | Michigan | 48075 | United States |
| St Lukes Cancer Center | Kansas City | Missouri | 64111 | United States |
| Christian Hospital | St Louis | Missouri | 63136 | United States |
| University of Nebraska | Omaha | Nebraska | 68198 | United States |
| Compehensive Cancer Care of Nevada | Las Vegas | Nevada | 89128 | United States |
| Virtua Health | Willingboro | New Jersey | 08046 | United States |
| Ashikari Breast Center | Cortlandt Manor | New York | 10567 | United States |
| Hematology Oncology Associates of Central New York | East Syracuse | New York | 13057 | United States |
| Theresa & Eugene M. Lang Research Center | Flushing | New York | 11355 | United States |
| Akron General Hospital | Akron | Ohio | 44302 | United States |
| University of Toledo | Toledo | Ohio | 43614 | United States |
| University of Oklahoma | Oklahoma City | Oklahoma | 73104 | United States |
| Breast Care Specialists | Allentown | Pennsylvania | 18104 | United States |
| ACMH Cancer Center | Kittanning | Pennsylvania | 16201 | United States |
| St. Mary Medical Center | Langhorne | Pennsylvania | 19047 | United States |
| Thomas Jefferson University | Philadelphia | Pennsylvania | 19107 | United States |
| St. Clair Hospital | Pittsburgh | Pennsylvania | 15243 | United States |
| The Breast Place | Charleston | South Carolina | 29406 | United States |
| Cancer Specialists of Charleston | Charleston | South Carolina | 29414 | United States |
| Coastal Carolina Breast Center | Murrells Inlet | South Carolina | 29576 | United States |
| Nashville Breast Center | Nashville | Tennessee | 37203 | United States |
| Texas Tech University | Amarillo | Texas | United States |
| Austin Cancer Center | Austin | Texas | 78303 | United States |
| Dallas Surgical Group | Dallas | Texas | 75230 | United States |
| Texas Health | Dallas | Texas | 75230 | United States |
| McAllen Oncology | Edinburg | Texas | United States |
| East Houston General Surgery | Houston | Texas | 77396 | United States |
| Kathryn A. Wagner Private Practice | San Antonio | Texas | 78205 | United States |
| Radiation Oncology of San Antonio | San Antonio | Texas | United States |
| Virginia Breast Care | Charlottesville | Virginia | 22911 | United States |
| Rockingham Memorial Hospital | Harrisonburg | Virginia | 22801 | United States |
| Lynchburg Hematology Oncology Clinic | Lynchburg | Virginia | 24501 | United States |
| Bon Secours Virginia Breast Center | Midlothian | Virginia | 23114 | United States |
| Swedish Cancer Institute | Seattle | Washington | 98104 | United States |
| Rockwood Clinic | Spokane | Washington | 99216 | United States |
| Bellin Hospital | Green Bay | Wisconsin | 54313 | United States |
| Columbia St. Marys Cancer Center | Milwaukee | Wisconsin | 53211 | United States |
| Waukesha Memorial Hospital | Waukesha | Wisconsin | 53188 | United States |
| Wheaton Franciscan Healthcare | Wauwatosa | Wisconsin | 53226 | United States |
| Derived |
| Whitworth PW, Beitsch PD, Pellicane JV, Baron PL, Lee LA, Dul CL, Murray MK, Gittleman MA, Budway RJ, Rahman RL, Kelemen PR, Dooley WC, Rock DT, Cowan KH, Lesnikoski BA, Barone JL, Ashikari AY, Dupree BB, Wang S, Menicucci AR, Yoder EB, Finn C, Corcoran K, Blumencranz LE, Audeh W; NBRST Investigators Group. Distinct Neoadjuvant Chemotherapy Response and 5-Year Outcome in Patients With Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Breast Tumors That Reclassify as Basal-Type by the 80-Gene Signature. JCO Precis Oncol. 2022 Apr;6(1):e2100463. doi: 10.1200/PO.21.00463. |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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