1. San Antonio Breast Cancer Symposium – December 6-10, 2016
The SCAN-B Study: 5-year summary of a large-scale population-based prospective breast cancer
translational genomics platform covering a wide geography of Sweden (ClinicalTrials.gov identifier NCT )
Anna Ehinger 1,2,3, Lao H Saal 1,2,4, Cecilia Hegardt 1,2,4, Johan Vallon-Christersson 1,2,4, Jari Häkkinen 1,2,3, Jonas Manjer 1,5, Christer Larsson 8, Niklas Loman 2,6, Lisa Rydén 1,7, Martin Malmberg 6, Fredrik Wärnberg 9, Henrik Lindman 10 , Bengt Asking 11 and Åke Borg 1,2,4
1 Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund. 2 Lund University Cancer Center, Lund, Sweden. 3 Department of Pathology and Cytology, Blekinge County Hospital, Karlskrona. 4 CREATE Health Strategic Center for Translational Cancer Research, Lund University, Lund. 5 Department of Surgery, Skåne University Hospital, Malmö. 6 Department of Oncology, Skåne University Hospital, Lund. 7 Department of Surgery, Skåne University Hospital, Lund. 8 Department of Laboratory Medicine, Division of Molecular Pathology, Lund University, Lund. 9 Department of Surgical Sciences, Uppsala Academic Hospital, Uppsala University, Uppsala. 10 Department of Oncology, Oncology and Radiation Science, Uppsala University Hospital, Uppsala University, Uppsala, 11 Department of Surgery, Ryhov Hospital, Jönköping.
Background
Breast cancer exhibits significant molecular, pathological, and clinical heterogeneity. Current clinicopathological evaluation is imperfect for predicting outcome, which results in overtreatment for many patients, and for others, leads to death from recurrent disease. Therefore, additional criteria are needed to better personalize care and maximize treatment effectiveness and survival. To address these challenges, large-scale population-based studies are needed to develop and evaluate new predictive biomarker tests under real-world conditions.
Results
Data generated for all samples include mRNA sequencing for quantifying gene expression and detection of expressed driver gene mutations. Prospective patient enrollment is ongoing and pilot clinical-reports, reported within 7 days of biopsy/surgery, are being evaluated at multidisciplinary breast cancer conferences. Reports include mRNA-seq based determination of molecular subtype, ER, PgR, HER2, Ki67, and tumor genomic grade.
Methods
In 2010 we initiated the Sweden Cancerome Analysis Network - Breast (SCAN-B) multicenter prospective study with longsighted aims to
analyze breast cancers with next-generation genomic technologies for translational research in a population-based manner and integrated with healthcare;
decipher fundamental tumor biology from these analyses;
utilize genomic data to develop and validate new clinically-actionable biomarker assays; and
establish real-time clinical implementation of molecular diagnostic and treatment-predictive tests..
For all patients, tumor biopsy and/or surgical tumor specimen and baseline blood samples are collected, as well as follow-up blood samples at defined intervals, and clinical data are obtained from regional and national databases. From all samples, DNA and RNA fractions are isolated, and tissue arrays are constructed. In the first phase, we focus on molecular profiling of tumor tissue by next-generation RNA-sequencing.
Eligibility will be extended to recurrent breast cancer in 2017. .
Conclusions
We demonstrate that population-based collection and real-time RNA-sequencing analysis of breast cancer is feasible at large-scale. The SCAN-B Study should significantly reduce the time to discovery, validation, and clinical implementation of novel molecular diagnostic and predictive tests.
References:
Saal LH, et al. The Sweden Cancerome Analysis Network - Breast (SCAN-B) Initiative: a large-scale multicenter infrastructure towards implementation of breast cancer genomic analyses in the clinical routine. Genome medicine ;7(1):20.
N=1551
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