Quality control for biomarker determination in oncology: the experience of the Italian Network for Quality Assessment of Tumor Biomarkers (INQAT).
Biomarker analysis and evaluation in oncology is the product of a number of processes (including managerial, technical and interpretation steps) which need to be monitored and controlled to prevent and correct errors and guarantee a satisfactory level of quality. Several biomarkers have recently moved to clinical validation studies and successively to clinical practice without any definition of standard procedures and/or quality control (QC) schemes necessary to guarantee the reproducibility of the laboratory information. In Italy several national scientific societies and single researchers have activated -- often on a pilot level -- specific external quality assessment protocols, thereby potentially jeopardizing the clinical reality even further. In view of the seriousness of the problem, in 1998 the Italian Ministry of Health sponsored a National Survey Project to coordinate and standardize the procedures and to develop QC programs for the analysis of cancer biomarkers of potential clinical relevance. Twelve QC programs focused on biomarkers and concerning morphological, immunohistochemical, biochemical, molecular, and immunoenzymatic assays were coordinated and implemented. Specifically, external QC programs for the analytical phase of immunohistochemical p53, Bcl-2, c-erb-2/neu/HER2, and microvessel density determination, of morphological evaluation of tumor differentiation grade, and of molecular p53 analysis were activated for the first time within the project. Several hundreds of Italian laboratories took part in these QC programs, the results of which are available on the web site of the Network (www.cqlaboncologico.it). Financial support from the Italian Government and the National Research Council (CNR) will guarantee the pursuit of activities that will be extended to new biomarkers, to preanalytical phases of the assays, and to revision of the criteria of clinical usefulness for evaluating the cost/benefit ratio.
Paradiso
A
A
Clinical Experimental Oncology Laboratory, National Cancer Institute of Bari, Italy. paradiso.io.bari@virgilio.it
Volpe
S
S
Iacobacci
A
A
Marubini
E
E
Verderio
P
P
Costa
A
A
Daidone
M G
MG
Marchetti
A
A
Mottolese
M
M
Amadori
D
D
De Paola
F
F
Saragoni
L
L
Medri
L
L
Nenci
I
I
Querzoli
P
P
Gion
M
M
Dittadi
R
R
Plebani
M
M
Orlando
C
C
Bevilacqua
G
G
Silvestrini
R
R
D001345:Autoradiography; D014408:Biomarkers, Tumor / Q000032:analysis*; D004273:DNA, Neoplasm / Q000032:analysis; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D009369:Neoplasms / Q000175:diagnosis* / Q000473:pathology; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D011786:Quality Control; D011987:Receptors, Steroid / Q000032:analysis; D016196:S Phase; D013936:Thymidine / Q000378:metabolism; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D019394:Ki-67 Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D011987:Receptors, Steroid; D016159:Tumor Suppressor Protein p53; D013936:Thymidine