Transcript ACRIN Breast Committee Overview

ACRIN Breast Committee
October 1, 2010
Constance Lehman, M.D., PhD, FACR
Professor and Vice Chair of Radiology
University of Washington
ACRIN Breast Committee
Breast Committee Members
Clinical Breast Imaging Radiologists–Constance Lehman, M.D. PhD
–Hiroyuke Abe, MD
–Wendie Berg, M.D. PhD
–Christiane Kuhl, MD
–Emily Conant, M.D
–Laurie Fajardo, M.D
–Ellen Mendelson, M.D
–Jay Baker, M.D
–Chris Comstock, M.D
–Sina Meisamy, MD
–Janie Lee, MD
• Other Radiologists with subspecialization in breast applications
–Mike Jacobs, M.D
–David Mankoff, M.D
–Marilyn Roubidoux, M.D.
ACRIN Breast Committee
•Other Disciplines
–Nancy Ellerbroek, M.D Radiation Oncology
–Tom Julian, M.D Surgical Oncology
–Shahla Masood, M.D Pathology
–Charlie Shapiro, M.D. Medical Oncology
–Isabelle Bedrosian, M.D. Surgical Oncology
•Physicists
–Ed Hendrick, PhD
–Nola Hylton, PhD
–Martin Yaffe, PhD
–Robert Nishikawa, PhD
ACRIN Breast Committee
•Statisticians/Epidemiologists
–Constantine Gatsonis, PhD
–Ben Herman, MS
–Zheng Zhang, PhD
•Others
–Barbara LeStage, Patient Advocate
–Nancy Sauers, Patient Advocate
–Judy Johnson, Patient Advocate
–Roslynn Marzan, Research Associate
–Bernadine Dunning
–Maxine Crooks
–Darryl L’Heureux
–Ashley Fails
ACRIN Breast Committee
•Historical strength of breast committee
–Assessment of diagnostic accuracy of relatively mature
technology
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Digital mammography for screening average risk populations
Ultrasound for screening high risk populations
MRI for screening contralateral breast/diagnosing EOD
DCE MRI to assess response to therapy
•Future development
–Develop and validate new imaging biomarkers to
predict and assess response to therapy
• Advanced MR imaging (MR spectroscopy, MR DWI),
Advanced PET applications, optical imaging
ACRIN Breast Committee
•SPECIFIC AIMS
•Test new screening strategies based on individualized risk
profiles.
•Assess the use of imaging for the measurement of extent of
disease and for monitoring and mid-therapy adaptation of
treatment protocols.
•Reduce the morbidity of breast cancer therapy through noninvasive imaging-guided mechanisms.
ACRIN Breast Committee
Aim 1: Targeted surveillance of at-risk
populations
Protocol Number 4006 – Tomosynthesis:
Comparison of Full Field Digital Mammography
with Digital Breast Tomosynthesis (T-MIST)
Image Acquisition and Projection Combinations
in relation to Screening Call-Back Rate
PI: Emily Conant, MD
ACRIN Breast Committee
Aim 2: Characterization of cancer in order
to drive targeted therapy
Protocols applying functional imaging methods
to determine the anatomic extent of tumor in
order to focus therapy
ACRIN 6694 ACOSOG collaboration pre op MRI
ACRIN DCIS trial—potential collaboration with
SWOG
ACRIN Breast Committee
Aim 3: Development of imaging-based
predictive and prognostic biomarkers of
response to targeted treatment.
6657 extension (MR diffusion, spectroscopy)
ISPY2 (6693)
EISC FLT study (6688)
ACRIN Breast Committee
• Concepts approved by ACRIN steering committee
–ACRIN Concept 6693: MR Imaging Biomarkers for Assessment of
Breast Cancer Response to Neoadjuvant Treatment: A sub-study of the
I-SPY 2 TRIAL (Investigation of Serial Studies to Predict Your
Therapeutic Response with Imaging And molecular Analysis)
PI: Nola Hylton, PhD
–ACRIN Concept 6694 – ACOSOG Z1101: Impact of Breast MRI on
Selection and Outcome of Breast Cancer Patients Undergoing Breast
Conserving Therapy
PI: Isabelle Bedrosian, MD, Surgery
PI: Chris Comstock, MD, Imaging
ACRIN Breast Committee
•3 Active Trials
– ACRIN 6683 CAD 1 is complete and was presented at 2009
RSNA. CAD 2 is was presented at this meeting and will be
presented at the 2010 RSNA.
– ACRIN 6657 ISPY Extension: Contrast Enhanced Breast MRI and
MRS for evaluation of Patients undergoing neoadjuvant treatment for
Locally Advanced Breast Cancer.
PI: Nola Hylton, PhD
Target accrual 140- accrual to date 114
– ACRIN 6688 Phase II study of 3’-Deoxy-3’ 18F Flourothymidine
(FLT) in Invasive Breast Cancer
PI- Lale Kostakoglu, MD
David Mankoff, MD PI
Target accrual 54- accrual to date 12
ACRIN Breast Committee
Papers Published 7/1/09-6/30/10
Manuscripts
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Comparison of Softcopy and Hardcopy Reading for Full-Field Digital
Mammography. Radiology, 252(1):41-49. April 2009. Nishikawa R;
Acharyya S; Gastonsis C; Pisano E; Cole E; Marques H; D’Orsi C,
Farria D; et al.
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Cancer Cases from ACRIN Digital Mammographic Imaging Screening
Trial: Radiologist Analysis with use of a Logistic Regression Model.
Radiology, 252(2):348-357. August 2009. Pisano E; Acharyya S; Cole
E; Marques H; Yaffe M; Blevins M; Conant E; Hendrick R; et al.
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Comparison of Acquisition Parameters and Breast Does in Digital
Mammography and Screen-Film Mammography in the ACRIN DMIST
Trial. American Journal of Roentgenology, 194:362-369. February
2010. Hendrick E, Pisano E; Averbukh A; Moran C; Berns A; Yaffe M;
Herman B; Acharyya S; Gatsonis C.
6667
Frequency of Malignancy in Probably Benign Lesions Seen on
Contrast-Enhanced Breast MRI. Radiology, 255:731-737. June 2010.
Weinstein S, Hanna L, Gatsonis C, Schnall M, Rosen M, Lehman C.
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Reasons Women at Elevated Risk of Breast Cancer Refuse Breast MR
Imaging Screening. Radiology, 254(1): 79-87. January 2010. Berg W;
Blume J; Adams A; Jong R; Barr R; Lehrer D; et al.
ACRIN Breast Committee
Abstracts Published 2009
Abstracts
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6657
6657
Title: Comparative Effectiveness and Cost-Effectiveness of Digital Mammography and MRI for Breast Cancer Screening in
BRCA1 Gene Mutation Carriers
Conference: 2009 Radiological Society of North America Annual Meeting (RSNA)
Presenter: Janie Lee, MD
Title: MRI Tumor Volume Predicts Response to Neoadjuvant Chemotherapy: Findings from the ACRIN Rrial 6657 (poster)
Conference: 2009 American Society of Clinical Oncology (ASCO)
Presenter: Nola Hylton, PhD
Title: Assessing Residual Disease in Breast Cancer Patients Post Neoadjuvant Chemotherapy Prior to Surgery: Findings of the
American College of Radiology Imaging Network (ACRIN) Trial 6657
Conference: 2009 Radiological Society of North America Annual Meeting (RSNA)
Presenter: Constance Lehman, MD, PhD
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Title: Screening Breast Ultrasound as a Supplement to Mammography: Yield of Annual Screening in ACRIN 6666
Conference: 2009 Radiological Society of North America Annual Meeting (RSNA)
Presenter: Wendie Berg, MD, PhD, FACR
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Title: False Positives Induced by Annual Screening US Added to Mammography: ACRIN 6666
Conference: 2009 Radiological Society of North America Annual Meeting (RSNA)
Presenter: Wendie Berg, MD, PhD, FACR
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Title: Supplemental Yield and Performance Characteristics of Screening MRI after Combined Ultrasound and Mammography:
ACRIN 6666
Conference: 2009 Radiological Society of North America Annual Meeting (RSNA)
Presenter: Wendie Berg, MD, PhD, FACR
6683
Title: CAD System Marking of Digital Mammograms of DMIST Cancers
Conference: 2009 Radiological Society of North America Annual Meeting (RSNA)
Presenter: Elodia Cole
ACRIN Breast Committee