HER2 testing of gastro-oesophageal adenocarcinoma: a commentary and guidance document from the Association of Clinical Pathologists Molecular Pathology and Diagnostics Committee

J Clin Pathol. 2018 May;71(5):388-394. doi: 10.1136/jclinpath-2017-204943. Epub 2018 Feb 8.

Abstract

The use of biologics targeted to the human epidermal growth factor receptor 2 (HER2) protein is the latest addition to the armamentarium used to fight advanced gastric or gastro-oesophageal junction adenocarcinoma. The decision to treat with the biologic trastuzumab is completely dependent on HER2 testing of tumour tissue. In 2017, the College of American Pathologists, American Society for Clinical Pathology and the American Society of Clinical Oncology jointly published guidelines for HER2 testing and clinical decision making in gastro-oesophageal adenocarcinoma. The Association of Clinical Pathologists Molecular Pathology and Diagnostics Committee has issued the following document as a commentary of these guidelines and, in parallel, to provide guidance on HER2 testing in National Health Service pathology departments within the UK. This guidance covers issues related to case selection, preanalytical aspects, analysis and interpretation of such HER2 testing.

Keywords: HER2; adenocarcinoma stomach; guidance; immunohistochemistry; in-situ hybridisation; oesophagus.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / enzymology*
  • Adenocarcinoma / genetics
  • Adenocarcinoma / pathology
  • Antineoplastic Agents, Immunological / therapeutic use
  • Biomarkers, Tumor / analysis*
  • Biomarkers, Tumor / genetics
  • Biopsy / standards
  • Clinical Decision-Making
  • Consensus
  • Esophageal Neoplasms / drug therapy
  • Esophageal Neoplasms / enzymology*
  • Esophageal Neoplasms / genetics
  • Esophageal Neoplasms / pathology
  • Esophagogastric Junction / drug effects
  • Esophagogastric Junction / enzymology*
  • Esophagogastric Junction / pathology
  • Humans
  • Immunohistochemistry / standards*
  • Molecular Diagnostic Techniques / standards*
  • Molecular Targeted Therapy
  • Pathology, Clinical / methods*
  • Pathology, Molecular / standards*
  • Precision Medicine / standards
  • Predictive Value of Tests
  • Receptor, ErbB-2 / analysis*
  • Receptor, ErbB-2 / antagonists & inhibitors
  • Receptor, ErbB-2 / genetics
  • Reproducibility of Results
  • Societies, Medical / standards*
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / enzymology*
  • Stomach Neoplasms / genetics
  • Stomach Neoplasms / pathology
  • Trastuzumab / therapeutic use

Substances

  • Antineoplastic Agents, Immunological
  • Biomarkers, Tumor
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Trastuzumab

Supplementary concepts

  • Adenocarcinoma Of Esophagus