MammaPrint Molecular Diagnostics on Formalin-Fixed, Paraffin-Embedded Tissue.

Publication Name: The Journal of Molecular Diagnostics

Author(s): Sapino A, Roepman P, Linn SC, Snel MHJ, Delahaye LJMJ, van den Akker J, Glas AM, Simon IM, Barth N, de Snoo FA, van 't Veer LJ, Molinaro L, Berns EMJJ, Wesseling J, Riley LB, Anderson D, Nguyen B, Cox

MammaPrint, a prognostic 70-gene profile for early-stage breast cancer, has been available for fresh tissue. Improvements in RNA processing have enabled microarray diagnostics for formalin-fixed, paraffin- embedded (FFPE) tissue. Here, we describe method optimization, validation, and performance of MammaPrint using analyte from FFPE tissue. Laboratory procedures for enabling the assay to be run on FFPE tissue were determined using 157 samples, and the assay was established using 125 matched FFPE and fresh tissues. Validation of MammaPrint FFPE, compared with MammaPrint fresh, was performed on an independent series of matched tissue from five hospitals (nZ211). Reproducibility, repeatability, and precision of the FFPE assay (nZ87) was established for duplicate analysis of the same tumor, inter laboratory performance, 20-day repeat experiments, and repeated analyses over 12 months. FFPE sample processing had a success rate of 97%. The MammaPrint assay using FFPE analyte demonstrated an overall equivalence of 91.5% (95% confidence interval, 86.9% to 94.5%) between the 211 independent matched FFPE and fresh tumor samples. Precision was 97.3%, and repeatability was 97.8%, with highly reproducible results between replicate samples of the same tumor and between two laboratories (concordance, 96%). Thus, with 580 tumor samples, MammaPrint was successfully translated to FFPE tissue. The assay has high precision and reproducibility, and FFPE results are substantially equivalent to results derived from fresh tissue. See article.