How to HER2
CAP, ASCP, and ASCO issue joint HER2 guidelines for GEA patients
William Aryitey |
Gastroesophageal adenocarcinoma (GEA) is consistently in the top five cancers globally, with over 43,000 cancer cases this year in the United States alone, and yet, in spite of this high prevalence, it still goes largely undiagnosed until the late stages. HER2-targeted therapies, best known for their role in breast cancer treatment, can offer some hope – but delayed diagnosis limits their effectiveness (1). In the absence of any clear guidance, and the insufficiency of HER2 testing guidance for breast cancer in this set of patients, the College of American Pathologists, the American Society for Clinical Pathology, and the American Society of Clinical Oncology teamed up to issue joint evidence-based guidelines for HER2 testing in GEA (1).
The expert panel created a list of 11 recommendations to ensure optimal HER2 testing – three specifically aimed at clinicians and eight at pathologists. Those for pathologists are listed in Table 1.
According to guideline Co-chair, Mary Kay Washington, a pathologist at Vanderbilt University Medical Center, “The pathologist can use the guidelines to decide which specimens might be best suited for testing,” adding, “it also provides a step-by-step procedure for the order in which the tests should be performed.” Given the high prevalence of the condition, Washington believes “this guideline has the potential to impact a large number of patients.”
- AN Bartley et al., “HER2 testing and clinical decision making in gastroesophageal adenocarcinoma: guideline from the College of American Pathologists, American Society for Clinical Pathologists, and American Society of Clinical Oncology”, Arch Pathol Lab Med, 140, 1345-1363 (2016). PMID: 27841667.