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Purpose: Luminal, human epidermal growth factor receptor 2-negative breast cancer represents the most common subtype of breast malignancies. Neoadjuvant strategies of operable breast cancer are mostly based on chemotherapy, whereas it is not completely understood which patients might benefit from neoadjuvant hormone therapy (NAHT)., Materials and Methods: The SAFIA trial is a prospective multicenter, international, double-blind, neoadjuvant phase III trial, using upfront 21-gene Oncotype DX Breast Recurrence Score assay (recurrence score [RS] < 31) to select operable luminal human epidermal growth factor receptor 2-negative patients, for induction hormonal therapy HT (fulvestrant 500 mg with or without goserelin) before randomly assigning responding patients to fulvestrant 500 mg (with or without goserelin) plus either palbociclib (cyclin-dependent kinase 4/6 inhibitor) or placebo. The objectives of this interim analysis were to assess the feasibility of upfront RS determination on core biopsies in the Middle-East and North Africa region and evaluate the efficacy of induction NAHT in patients with an RS < 31., Results: At the time of this interim analysis, 258 patients with relative risk were accrued, including 202 patients (RS < 31% to 78.3%) treated with induction NAHT and 182 patients evaluable so far for response. The feasibility of performing the Oncotype DX assays on core biopsy specimens was optimal in 96.4% of cases. Overall, 93.4% of patients showed hormone sensitivity and no difference in NAHT efficacy was noticed between RS 0-10, 11-25, and 26-30. Interestingly, patients with high RS (26-30) showed a trend toward a higher major response rate ( P = .05)., Conclusion: The upfront 21-gene assay performed on biopsies is feasible in our population and has allowed us to select patients with high hormone sensitivity (RS < 31). This approach could be an alternative to upfront surgery without significant risk of progression, particularly during pandemic times., Competing Interests: Khalid AlSalehHonoraria: Amgen, AstraZeneca, Novartis, Pfizer, RocheResearch Funding: Pfizer, AstraZeneca Mohammed OukkalConsulting or Advisory Role: Amgen, Roche, Novartis, PfizerSpeakers' Bureau: Bayer, Ipsen Ahmed SaadeddinConsulting or Advisory Role: NovartisTravel, Accommodations, Expenses: Novartis, Roche, MSD, Sanofi Kamel BouzidConsulting or Advisory Role: Roche, Pfizer, MSD Oncology, Merck, SANFI, Mylan Omalkhair AbulkhairTravel, Accommodations, Expenses: MSD, Roche Meteb Al-FoheidiHonoraria: Pfizer, Lilly, Roche, NovartisConsulting or Advisory Role: NovartisSpeakers' Bureau: Pfizer, Roche, AstraZeneca, Novartis, LillyTravel, Accommodations, Expenses: Pfizer, Roche, Novartis, AstraZeneca Hassan ErrihaniConsulting or Advisory Role: Pfizer, Roche, MSD, Merck, Janssen Oncology, AstraZenecaSpeakers' Bureau: Novartis, Amgen, Astellas Pharma, ServierResearch Funding: RocheTravel, Accommodations, Expenses: Pierre Fabre, Merck Marwan GhosnConsulting or Advisory Role: Bayer, MSD Oncology, Bristol Myers Squibb, Pfizer, Novartis, Sanofi, Lilly, Astellas PharmaResearch Funding: Pfizer, Novartis, SanofiTravel, Accommodations, Expenses: Astellas Pharma, Bristol Myers Squibb, Celgene Haleem RasoolTravel, Accommodations, Expenses: Bayer Mohun BahadoorTravel, Accommodations, Expenses: Pfizer Sharif KullabTravel, Accommodations, Expenses: Pfizer Jean-Marc NabholtzConsulting or Advisory Roles: Pfizer, AstraZeneca, Genomic Health, MSD, RocheHonoraria: Pfizer, AstraZeneca, AMGEN, Novartis, RocheResearch Funding: Pfizer, AstraZeneca, Genomic HealthTravel, Accommodations, Expenses: Pfizer, AstraZeneca, Roche, NovartisNo other potential conflicts of interest were reported.

Background: The Gulf Cooperation Council (GCC) countries have witnessed over the last 40 years a rapid and major social, cultural, and economic transformation. The development of medical education in the region is relatively new, dating from the late 1960s. An important goal among the medical colleges in the region is to graduate national physicians who can populate the healthcare service of each country., Aim: The aim of this study is to provide understanding of undergraduate medical education in each of the six GCC countries and the challenges that each face., Methods: This is a descriptive cross-sectional study. Fourteen senior medical faculty were requested to submit information about undergraduate medical education in their own countries, focusing on its historical background, student selection, curriculum, faculty, and challenges., Results: The information provided was about 27 medical colleges: 16 from the Kingdom of Saudi Arabia (KSA), five from the United Arab Emirates, two from the Kingdom of Bahrain, two from Sultanate of Oman, one from Kuwait and one from the State of Qatar. It was found that older colleges are reviewing their curriculum while new colleges are developing their programs following current trends in medical education particularly problem-based learning and integrated curricula. The programs as described 'on paper' look good but what needs to be evaluated is the curriculum 'in action'. Faculty development in medical education is taking place in most of the region's medical colleges., Conclusion: The challenges reported were mainly related to shortages of faculty, availability of clinical training facilities, and the need to more integration with the National Health Care services. Attention to quality, standards, and accreditation is considered essential by all colleges.