HER2 testing and clinical decision making in gastroesophageal adenocarcinoma: Guideline from the College of American Pathologists, American Society for Clinical Pathology, and the American Society of Clinical Oncology Journal Article


Authors: Bartley, A. N.; Washington, M. K.; Colasacco, C.; Ventura, C. B.; Ismaila, N.; Benson, A. B. 3rd; Carrato, A.; Gulley, M. L.; Jain, D.; Kakar, S.; Mackay, H. J.; Streutker, C.; Tang, L.; Troxell, M.; Ajani, J. A.
Article Title: HER2 testing and clinical decision making in gastroesophageal adenocarcinoma: Guideline from the College of American Pathologists, American Society for Clinical Pathology, and the American Society of Clinical Oncology
Abstract: Context ERBB2 (erb-b2 receptor tyrosine kinase 2 or HER2) is currently the only biomarker established for selection of a specific therapy for patients with advanced gastroesophageal adenocarcinoma (GEA). However, there are no comprehensive guidelines for the assessment of HER2 in patients with GEA. Objectives To establish an evidence-based guideline for HER2 testing in patients with GEA, formalize the algorithms for methods to improve the accuracy of HER2 testing while addressing which patients and tumor specimens are appropriate, and to provide guidance on clinical decision making. Design The College of American Pathologists (CAP), American Society for Clinical Pathology (ASCP), and the American Society of Clinical Oncology (ASCO) convened an Expert Panel to conduct a systematic review of the literature to develop an evidence-based guideline with recommendations for optimal HER2 testing in patients with GEA. Results The Panel is proposing 11 recommendations with strong agreement from the open comment participants. Recommendations The Panel recommends that tumor specimen(s) from all patients with advanced GEA, who are candidates for HER2-targeted therapy, should be assessed for HER2 status before the initiation of HER2-targeted therapy. Clinicians should offer combination chemotherapy and an HER2-targeted agent as initial therapy for all patients with HER2-positive advanced GEA. For pathologists, guidance is provided for morphologic selection of neoplastic tissue, testing algorithms, scoring methods, interpretation and reporting of results, and laboratory quality assurance. Conclusion This guideline provides specific recommendations for assessment of HER2 in patients with advanced GEA while addressing pertinent technical issues and clinical implications of the results.
Journal Title: Journal of Clinical Oncology
Volume: 35
Issue: 4
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2017-02-01
Start Page: 446
End Page: 464
Language: English
ACCESSION: 121017568
DOI: 10.1200/jco.2016.69.4836
PROVIDER: EBSCOhost
PUBMED: 28129524
PROVIDER: cin20
DOI/URL:
Notes: Accession Number: 121017568 -- Entry Date: In Process -- Revision Date: 20170201 -- Publication Type: journal article -- Journal Subset: Biomedical; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA -- NLM UID: 8309333 -- Source: cin20
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  1. Laura Hong Tang
    319 Tang
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