Variation in the Attitudes of Medical Oncologists Toward Research Biopsies in Patients With Metastatic Breast Cancer

Seah, Davinia; Guo, Hao; Najita, Julie; Lederman, Ruth I.; Frank, Elizabeth S.; Sohl, Jessica; Stadler, Zsofia K.; Silverman, Stuart G.; Peppercorn, Jeffrey; Winer, Eric P.; Come, SE; Lin, Nancy U.

doi:10.1634/theoncologist.2015-0112

Cited by 8 publications

(11 citation statements)

References 19 publications

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“…The study of cancer metastasis, by contrast, is often hindered by a lack of optimal model systems to decipher the interaction between cancer cells and the tumor microenvironment at the metastatic site. Finally, from the therapeutic perspective, many primary cancers can be cured either by surgery and/or adjuvant therapy, while there is a general lack of confidence in the curability of cancer metastasis [14] , [15] , [16] , which often leads to the patient's demise. It is challenging for investigators to establish reliable in vitro models to delineate the mechanism of cancer metastasis at an organismic level.…”

Section: Limitations In the Research Of Cancer Metastasismentioning

confidence: 99%

Cultured circulating tumor cells and their derived xenografts for personalized oncology

Wang

Chu

Mrđenović

et al. 2016

Asian Journal of Urology

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Recent cancer research has demonstrated the existence of circulating tumor cells (CTCs) in cancer patient's blood. Once identified, CTC biomarkers will be invaluable tools for clinical diagnosis, prognosis and treatment. In this review, we propose ex vivo culture as a rational strategy for large scale amplification of the limited numbers of CTCs from a patient sample, to derive enough CTCs for accurate and reproducible characterization of the biophysical, biochemical, gene expressional and behavioral properties of the harvested cells. Because of tumor cell heterogeneity, it is important to amplify all the CTCs in a blood sample for a comprehensive understanding of their role in cancer metastasis. By analyzing critical steps and technical issues in ex vivo CTC culture, we developed a cost-effective and reproducible protocol directly culturing whole peripheral blood mononuclear cells, relying on an assumed survival advantage in CTCs and CTC-like cells over the normal cells to amplify this specified cluster of cancer cells.

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Section: Limitations In the Research Of Cancer Metastasismentioning

confidence: 99%

Cultured circulating tumor cells and their derived xenografts for personalized oncology

Wang

Chu

Mrđenović

et al. 2016

Asian Journal of Urology

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“…Both the willingness of patients and the reluctance of the treating physician to ask their patients for research biopsies play a role here. This is a common phenomenon in the process of acquiring research biopsies and has recently been described elsewhere . Consequently, many of the early‐phase clinical trials that include mandatory biopsies fail to report on biomarker analysis .…”

Section: Discussionmentioning

confidence: 92%

Implementation of a Multicenter Biobanking Collaboration for Next-Generation Sequencing-Based Biomarker Discovery Based on Fresh Frozen Pretreatment Tumor Tissue Biopsies

et al. 2017

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Image-guided biopsy procedures for biomarker discovery to enable personalized cancer treatment are safe and feasible and yield a highly valuable biobank. The Oncologist 2017;22:33-40Implications for Practice: This study shows that it is safe to perform image-guided biopsy procedures to obtain fresh frozen tumor samples and that it is feasible to use these biopsies for biomarker discovery purposes in a Dutch multicenter collaboration. From the majority of the samples, sufficient DNA could be yielded to perform next-generation sequencing. These results indicate that the way is paved for consortia to prospectively collect fresh frozen tumor tissue.

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“…Liquid biopsies may be particularly beneficial to reassess the mutations present when the cancer spreads to another part of the body (relapse, or metastases) and is not easily accessible for biopsy. This is important as clinicians are more reluctant to approach patients for biopsies of metastatic disease sites [ 4 , 6 , 22 ]. However, in order to evaluate the use of ctDNA as a screening tool there is a need to compare liquid biopsy results with the results obtained from a tissue sample biopsy to ensure the ctDNA screening is reliable and accurate.…”

Section: Main Textmentioning

confidence: 99%

“…The biological analysis of sequential biopsies obtained before, during and after treatment can reveal how the cancer changes over time and responds to the treatment. Therefore, obtaining additional breast cancer tissue during treatment has become an integral component in breast cancer research [ 4 ]. Knowing which patient population may be responsive to treatment and which biological markers may indicate resistance has the potential to reduce the risk of patient exposure to treatment that is unlikely to be of benefit, and increase the likelihood of patient exposure to active treatment.…”

Section: Introductionmentioning

confidence: 99%

“…One of the main challenges faced in the collection of multiple tissue biopsies is the perception of clinicians that patients may not wish to be approached for the additional biopsies, or they may not want to subject patients to additional procedures that would not be routinely performed as part of standard of care. The reasons cited for not wanting to approach patients for additional biopsies include the risk associated with the biopsy procedure, the pain or discomfort of a biopsy and the inconvenience to patients [ 4 ]. Whilst studies have shown that patients are willing to provide research biopsies even when there is no direct benefit to them [ 5 – 9 ], treating clinicians and other research staff may remain reluctant due to perceived ideas of what is acceptable.…”

Section: Introductionmentioning

confidence: 99%

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Patient advocate involvement in the design and conduct of breast cancer clinical trials requiring the collection of multiple biopsies

et al. 2018

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Plain English summaryBreast cancer is a diverse and varied disease. Recent research has shown that the collection of multiple biopsies before surgery can help researchers determine how the cancer is responding to treatment and can predict for long-term outcomes. However biopsies can be uncomfortable, and sometimes clinicians and research teams in hospitals may be reluctant to offer clinical trials requiring several biopsies to patients who have been recently diagnosed with breast cancer. The Institute of Cancer Research Clinical Trials and Statistics Unit (ICR-CTSU) oversees a large number of breast cancer clinical trials where multiple biopsies are required. ICR-CTSU recognises that patient advocates (patients who have previously had, or cared for someone with, cancer) are key members of the trial design group and should be involved in the clinical trial throughout its lifespan. Patient advocates can provide reassurance regarding the acceptability of trial designs involving multiple biopsies from a patient perspective. This paper summarises patient advocate involvement in ICR-CTSU breast cancer trials activity and how this has benefited our research.AbstractThe importance of collecting tissue samples in breast cancer has become increasingly recognised, as the diversity of the disease has become better known. It has been documented in recent research that tumours may change in response to treatment prior to surgery (the neoadjuvant treatment setting). The collection of sequential biopsies over time can identify changes within tumours and potentially predict how the tumour may respond to certain treatments. However, the acceptability of multiple biopsies amongst patients, clinicians and other research staff in hospitals is variable and recruitment into clinical trials requiring multiple biopsies may be challenging.The Institute of Cancer Research Clinical Trials and Statistics Unit (ICR-CTSU) is responsible for a portfolio of breast cancer trials where multiple biopsies are key to the trial design. Patient advocate involvement has been essential in helping us to design and deliver complex and innovative cancer trials which require multiple invasive tissue biopsies, often without any direct benefit to the trial participants. The views expressed by patient advocates involved in ICR-CTSU trials supports the published evidence that patients are willing to donate additional tissue for research and that clinicians’ concerns about approaching patients for trials involving multiple biopsies are often unfounded.Patient advocate involvement in ICR-CTSU trials activity takes various forms, from membership on protocol development groups and trial management groups, attendance at focus groups and forums, and presentations at trial development and launch meetings. This involvement has provided reassurance to research teams within the NHS and research ethics committees of the importance and acceptability of our trials from a patient perspective. Patient advocate involvement throughout the lifetime of our trials ensures that the ...

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Variation in the Attitudes of Medical Oncologists Toward Research Biopsies in Patients With Metastatic Breast Cancer

Cited by 8 publications

References 19 publications

Cultured circulating tumor cells and their derived xenografts for personalized oncology

Cultured circulating tumor cells and their derived xenografts for personalized oncology

Implementation of a Multicenter Biobanking Collaboration for Next-Generation Sequencing-Based Biomarker Discovery Based on Fresh Frozen Pretreatment Tumor Tissue Biopsies

Patient advocate involvement in the design and conduct of breast cancer clinical trials requiring the collection of multiple biopsies

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