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. 2013 Oct 11:13:472.
doi: 10.1186/1471-2407-13-472.

Improvement of the quality of BRAF testing in melanomas with nationwide external quality assessment, for the BRAF EQA group

Jean-François Emile  1 , Julie Tisserand, Loic Bergougnoux, Frédérique Nowak, Gladwys Faucher, Sylvie Surel, Aude Lamy, Delphine Lecorre, Zofia Helias-Rodzewicz, Paul Hofman, Jean-Christophe Sabourin, Pierre Laurent-Puig; BRAF EQA Group
Collaborators, Affiliations

Improvement of the quality of BRAF testing in melanomas with nationwide external quality assessment, for the BRAF EQA group

Jean-François Emile et al. BMC Cancer. .

Abstract

Background: Knowledge about tumour gene mutation status is essential for the treatment of increasing numbers of cancer patients, and testing quality has a major impact on treatment response and cost. In 2012, 4,629 tests for BRAF p.V600 were performed in France, in patients with melanomas.

Methods: Two batches of unstained melanoma sections were sent, in May and November 2012, to the 46 laboratories supported by the French National Institute of Cancer (INCa). An external quality assessment (EQA) evaluated mutation status, response times and compliance with INCa recommendations.

Results: All the French laboratories involved in testing participated in the EQA. Fourteen different methods were used to detect BRAF mutations, most consisting of combinations of in-house techniques. False responses were noted in 25/520 cases (4.8%), 11 of which concerned confusion between p.V600E and p.V600K. Thus, 2.7% of responses would have led to inappropriate treatment. Within six months, mean response times decreased from 22 to 12 days (P<0.001), and the percentage of samples evaluated by a pathologist for tumour cell content increased, from 75.2% to 96.9% (P<0.001).

Conclusion: Despite the use of non-certified methods, the false response rate was low. Nationwide EQA can improve the quality of molecular pathology tests on tumours.

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Figures

Figure 1
Figure 1
BRAF p.V600 status responses obtained from the 46 French laboratories. Among the 12 samples tested, two had more than 20%, and three others had only a few (<5%) false responses.
Figure 2
Figure 2
Response time. Response time, corresponding to the number of days between delivery by the transporter and reception of the report by the correspondent significantly improved (P<0.001) over the six-month period between the two tests (tests #1 and #2 were performed in May and November 2012, respectively).
See this image and copyright information in PMC

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