A Noninvasive Blood-based Combinatorial Proteomic Biomarker Assay to Detect Breast Cancer in Women over age 50 with BI-RADS 3, 4, or 5 Assessment

• Published in: Clinical cancer research 2019-01, Vol.25 (1), p.142-149
• Main Authors: Henderson, Meredith C, Silver, Michael, Tran, Quynh, Letsios, Elias E, Mulpuri, Rao, Reese, David E, Lourenco, Ana P, LaBaer, Joshua, Anderson, Karen S, Alpers, Josie, Costantini, Carrie, Rohatgi, Nitin, Ali, Haythem, Baker, Karen, Northfelt, Donald W, Ghosh, Karthik, Grobmyer, Stephen R, Polen, Winnie, Wolf, Judith K
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biomarkers, Tumor - blood; Biopsy; Breast - diagnostic imaging; Breast - metabolism; Breast - pathology; Breast Neoplasms - blood; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - genetics; Breast Neoplasms - pathology; Female; Humans; Mammography; Middle Aged; Proteomics
• ISSN: 1078-0432; 1557-3265
• DOI: 10.1158/1078-0432.CCR-18-0843

With improvements in breast cancer imaging, there has been a corresponding increase in false-positives and avoidable biopsies. There is a need to better differentiate when a breast biopsy is warranted and determine appropriate follow-up. This study describes the design and clinical performance of a combinatorial proteomic biomarker assay (CPBA), Videssa Breast, in women over age 50 years. A BI-RADS 3, 4, or 5 assessment was required for clinical trial enrollment. Serum was collected prior to breast biopsy and subjects were followed for 6-12 months and clinically relevant outcomes were recorded. Samples were split into training (70%) and validation (30%) cohorts with an approximate 1:4 case:control ratio in both arms. A CPBA that combines biomarker data with patient clinical data was developed using a training cohort (469 women, cancer incidence: 18.5%), resulting in 94% sensitivity and 97% negative predictive value (NPV). Independent validation of the final algorithm in 194 subjects (breast cancer incidence: 19.6%) demonstrated a sensitivity of 95% and a NPV of 97%. When combined with previously published data for women under age 50, Videssa Breast achieves a comprehensive 93% sensitivity and 98% NPV in a population of women ages 25-75. Had Videssa Breast results been incorporated into the clinical workflow, approximately 45% of biopsies might have been avoided. Videssa Breast combines serum biomarkers with clinical patient characteristics to provide clinicians with additional information for patients with indeterminate breast imaging results, potentially reducing false-positive breast biopsies.