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HER2 testing in gastric and gastroesophageal junction cancers: a new therapeutic target and diagnostic challenge

David G Hicks1, Christa Whitney-Miller

  • 1Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA. david_hicks@urmc.rochester.edu

Applied Immunohistochemistry & Molecular Morphology : AIMM
|November 18, 2011
PubMed

Insights

Trastuzumab improves survival for advanced stomach and gastroesophageal junction cancers. Diagnostic labs need human epidermal growth factor receptor 2 testing for these new treatments.

Area of Science:

  • Medical Oncology
  • Gastroenterology
  • Pathology

Background:

  • Gastric and gastroesophageal junction adenocarcinomas cause significant global morbidity and mortality.
  • Many patients present with unresectable locally advanced or metastatic disease, highlighting a need for novel therapies.
  • Surgical resection is primary for nonmetastatic cases, but new treatment options are crucial.

Purpose of the Study:

  • To evaluate the efficacy of trastuzumab in advanced gastric and gastroesophageal junction cancers.
  • To inform pathologists and laboratories about new diagnostic requirements for targeted therapy.

Main Methods:

  • Clinical trial evaluating trastuzumab treatment protocols.
  • Analysis of overall survival data in patients with advanced disease.
  • Review of diagnostic testing requirements for human epidermal growth factor receptor 2 (HER2).

Main Results:

  • Patients receiving trastuzumab demonstrated improved overall survival compared to controls.
  • Trastuzumab is now approved for advanced gastric and gastroesophageal junction cancers.
  • HER2 testing is essential for identifying eligible patients.

Conclusions:

  • Trastuzumab offers a new therapeutic strategy for advanced gastric and gastroesophageal junction adenocarcinomas.
  • Pathology laboratories must adapt to HER2 testing for these cancers.
  • Understanding interpretive differences between breast and gastric cancer HER2 testing is vital.

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