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. 2023 Feb 24;9(1):8.
doi: 10.1038/s41523-023-00510-9.

PROCURE European consensus on breast cancer multigene signatures in early breast cancer management

Giuseppe Curigliano  1   2 , Fatima Cardoso  3 , Michael Gnant  4 , Nadia Harbeck  5 , Judy King  6 , Anne-Vibeke Laenkholm  7 , Frédérique Penault-Llorca  8 , Aleix Prat  9
Affiliations

PROCURE European consensus on breast cancer multigene signatures in early breast cancer management

Giuseppe Curigliano et al. NPJ Breast Cancer. .

Abstract

Breast cancer multigene signatures (BCMS) have changed how patients with early-stage breast cancer (eBC) are managed, as they provide prognostic information and can be used to select patients who may avoid adjuvant chemotherapy. Clinical guidelines make recommendations on the use of BCMS; however, little is known on the current use of BCMS in clinical practice. We conduct a two-round Delphi survey to enquire about current use and perceived utility for specific patient profiles, and unmet needs of BCMS. Overall, 133 panellists experienced in breast cancer across 11 European countries have participated, most using BCMS either routinely (66.2%) or in selected cases (27.1%). Our results show that BCMS are mainly used to assess the risk of recurrence and to select patients for adjuvant chemotherapy; notably, no consensus has been reached on the lack of utility of BCMS for selecting the type of chemotherapy to administer. Also, there are discrepancies between the recommended and current use of BCMS in clinical practice, with use in certain patient profiles for which there is no supporting evidence. Our study suggests that physician education initiatives are needed to ensure the correct use and interpretation of BCMS to, ultimately, improve management of patients with eBC.

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Conflict of interest statement

The Authors declare no Competing Non-Financial Interests but the following Competing Financial Interests: G.C. declares that he has received personal fees for his participation in the PROCURE Project as a member of the Steering Committee and his role as coordinator of the study. He also reports advisory board roles for Pfizer, Novartis, Lilly, Seagen, Amgen, Roche, Astra Zeneca, Daichii Sankyo, Celcuity, Veracyte and Gilead outside the submitted work. He has also received institutional financial support for clinical trials from: Amgen, Astra-Zeneca, Boehringer-Ingelheim, Bristol-Myers-Squibb, Bayer, Daiichi-Sankyo, GlaxoSmithKline, Incyte, Nektar Therapeutics, Novartis, Macrogenics, Merck, Pfizer, Pierre-Fabre, Roche, Sanofi-Aventis, Taiho Oncology, Tesaro, Blueprint, Seagen. F.C. declares that she has not received any economic compensation for her participation in the PROCURE Project. She declares advisory/consultancy role for: Amgen, Astellas/Medivation, AstraZeneca, Celgene, Daiichi-Sankyo, Debiopharm, Eisai, GE Oncology, Genentech, Gilead, GlaxoSmithKline, Iqvia, Macrogenics, Medscape, Merck-Sharp, Merus BV, Mylan, Mundipharma, Novartis, Pfizer, Pierre-Fabre, prIME Oncology, Roche, Sanofi, Samsung Bioepis, Seagen, Teva, Touchime. She has also received institutional financial support for clinical trials from: Amgen, Astra-Zeneca, Boehringer-Ingelheim, Bristol-Myers-Squibb, Bayer, Daiichi, Eisai, Fresenius GmbH, Genentech, GlaxoSmithKline, Ipsen, Incyte, Nektar Therapeutics, Nerviano, Novartis, Macrogenics, Medigene, MedImmune, Merck, Millenium, Pfizer, Pierre-Fabre, Roche, Sanofi-Aventis, Sonus, Taiho Oncology, Tesaro, Tigris, Wilex, Wyeth. M.G. declares that he has received personal fees for his participation in the PROCURE Project as a member of the Steering Committee. He also reports personal fees/travel support from Amgen, DaiichiSankyo, AstraZeneca, EliLilly, LifeBrain, Nanostring, Novartis, PierreFabre, MSD; an immediate family member is employed by Sandoz. N.H. declares that she has received personal fees for her participation in the PROCURE Project as a member of the Steering Committee. She also declares that she has received honoraria for lectures and/or consulting from Amgen, AstraZeneca, Daiichi-Sankyo, Exact Sciences, Gilead, Lilly, MSD, Novartis, Pierre-Fabre, Pfizer, Roche, Sandoz, and Seagen. J.K. declares that she has received personal fees for her participation in the PROCURE Project as a member of the Steering Committee. She also reports advisory role for Roche, Pfizer, AstraZeneca, Gilead, and Lilly and speaker bureau roles for Pfizer, Roche, Seagen, and Novartis. A.V.L. declares that she has received personal fees for her participation in the PROCURE Project as a member of the Steering Committee. She also reports advisory board roles for AstraZeneca, Novartis, and MSD. She has also received institutional research funding from Novartis and AstraZeneca. F.P.L. declares that she has received personal fees for her participation in the PROCURE Project as a member of the Steering Committee. She also declares fees from AbbVie, Agendia, Astellas, AstraZeneca, Bayer, BMS, Eisai, Exact Sciences, GSK, Janssen, Lilly, MERCK Life, MSD, Myriad, Novartis, Pfizer, Pierre-Fabre, Roche, Sanofi, Servier, Veracyte. A.P. declares that he has received personal fees for his participation in the PROCURE Project as a member of the Steering Committee. He also declares that he has received lecture fees from Roche, Pfizer, Novartis, Amgen, BMS, Nanostring Technologies, and Daiichi Sankyo; advisory role/consultancy fees from Roche, Pfizer, Novartis, Amgen, BMS, Puma, Oncolytics Biotech, MSD, Guardan Health, Peptomyc and Lilly; and fees for leadership role from Reveal Genomics, SL. He has also received fees for research from Boehringer, Novartis, Roche, Nanostring, Sysmex Europa GmbH, Medica Scientia inno. Research, SL, Celgene, Astellas and Pzifer; lecture fees from Nanostring technologies and fees for developing clinical trials from Boehringer, Lilly, Roche, Novartis, Amgen and Daiichi Sankyo. Finally, he has received fees for his leadership role in executive boards for Reveal Genomics, SL and SOLTI cooperative group and for participating in a patronage committee for SOLTI Foundation and Actitud Frente al Cáncer Foundation.

Figures

Fig. 1
Fig. 1. Reasons for use of breast cancer multigene signatures in patients with early-stage breast cancer.
Percentage of panellists ranking the importance of reasons for using BCMS from least important (1) to most important (7).
Fig. 2
Fig. 2. Information included in the pathology or surgical sample report of patients with breast cancer.
Percentage of panellists stating the parameters that are included in the report. ER oestrogen receptor, IHC immunohistochemistry, PR progesterone receptor.
Fig. 3
Fig. 3. Use of breast cancer multigene signatures to define prognosis and treatment decisions.
Percentage of panellists stating the patient profiles with early breast cancer for which they use BCMS to define prognosis and treatment needs. LN lymph node, PR progesterone receptor.
See this image and copyright information in PMC

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