Proposals for uniform collection of biospecimens from neoadjuvant breast cancer clinical trials: timing and specimen types

• Published in: The lancet oncology Vol. 12; no. 12; pp. 1162 - 1168
• Main Authors: Loi, Sherene, MD, Symmans, W Fraser, Prof, Bartlett, John MS, Prof, Fumagalli, Debora, MD, Veer, Laura Van't, Prof, Forbes, John F, Prof, Bedard, Philippe, MD, Denkert, Carsten, MD, Zujewski, JoAnne, MD, Viale, Giuseppe, Prof, Pusztai, Lajos, Prof, Esserman, Laura J, Prof, Leyland-Jones, Brian R, Prof
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2011; Elsevier Limited
• Subjects: Biomarkers; Biopsy; Biopsy - standards; Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - therapy; Cancer therapies; Clinical trials; Clinical Trials as Topic - standards; Female; Fixatives - standards; Formaldehyde - standards; Hematology, Oncology and Palliative Medicine; Humans; Molecular Diagnostic Techniques - standards; Neoadjuvant Therapy; Paraffin Embedding - standards; Patients; Practice Guidelines as Topic; Predictive Value of Tests; Specimen Handling - standards; Time Factors; Tissue Fixation - standards; Womens health
• ISSN: 1470-2045; 1474-5488
• DOI: 10.1016/S1470-2045(11)70117-6

Summary In this Personal View, we outline proposals for uniform collection of biospecimens obtained in neoadjuvant breast cancer trials undertaken by the Breast International Group (BIG) and the National Cancer Institute-sponsored North American Breast Cancer Group (NABCG). These proposals aim to standardise collection of high-quality specimens, with respect to both type and timing, to enhance and allow integration of results obtained from neoadjuvant trials done by several groups. They should be considered in parallel with recommendations for tissue-specimen collection and handling previously developed by BIG and NABCG. We propose that tumour tissue (formalin-fixed, paraffin-embedded and samples dedicated for molecular studies) should be taken at baseline, 1–3 weeks after the start of treatment, and at definitive surgery, with clear prioritisation in the study protocol of number, order, and preservation of samples to be gathered. This step should be accompanied by blood collection (plasma, serum, and whole blood) whenever possible. We advocate strongly a move towards one diagnostic and research biopsy procedure in all women with breast cancers potentially suitable for neoadjuvant treatment. If possible, patients should be referred at the outset to specialised centres to give them the opportunity to participate in neoadjuvant clinical trials, thereby avoiding several biopsy procedures.