HER2 testing in gastric cancer: a practical approach

摘要: Trastuzumab in combination with capecitabine or 5-fluorouracil and cisplatin is approved by the European Medicines Agency for treatment of patients human epidermal growth factor receptor 2 (HER2)-positive (immunohistochemistry 3+ immunohistochemistry 2+/fluorescence situ hybridization-positive 2+/silver hybridization-positive) metastatic adenocarcinoma stomach gastro-esophageal junction. Approvals are underway other countries, recent approvals granted United States Japan. Experience data from trastuzumab use breast cancer have highlighted importance quality HER2 testing scoring to ensure accurate identification eligible treatment. gastric differs due inherent differences tumor biology; more frequently shows heterogeneity (focal staining) incomplete membrane staining. Consequently, cancer-specific protocols been developed standardized it imperative that these recommendations be adhered to. Given predictive value protein levels response GAstric study (ToGA), should initial methodology fluorescence hybridization silver used retest 2+ samples. Wherever possible, bright-field methodologies as considered superior fluorescent at identifying heterogeneous Specific training required before embarking on cancer, irrespective experience cancer. This paper provides most up-to-date practical guidance junction agreed a panel expert pathologists extensive particularly reflecting Agency-approved indication. It anticipated consistent testing, which will allow appropriate selection trastuzumab.