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Introduction:
Gastric cancer, among the most prevalent digestive system malignancies worldwide, significantly impacts global health. The identification of epidermal growth factor receptor 2 HER2 status is crucial for accurate molecular typing and tlored therapy choice in gastric cancer patients, including those with gastric-esophageal junction adenocarcinomas. This consensus paper encapsulates the state-of-the-art evidence and international guidelines concerning HER2 expression testing on gastric biopsy samples.
Background:
The detection of HER2, a receptor implicated in various cancers, is essential for stratifying gastric cancer into different subtypes, thus guiding targeted therapies that exploit this biological pathway. HER2 expression in gastric cancers has been linked to improved outcomes with specific therapeutics targeting this receptor.
Key Recommations:
Following an exhaustive review of the evidence base and international best practices, several critical recommations emerge:
Biopsy Selection: Opt for biopsy samples obtned from deep gastric tumors rather than superficial ones or ulcer edges. This ensures a more representative assessment of HER2 expression levels across the entire tumor.
Specimen Handling: Mntn strict cold-chn preservation throughout handling and transport to prevent degradation of biomarkers that could affect detection accuracy.
IHC Protocol: Employ standardized immunohistochemistry IHC protocols with validated antibodies, adhering to the manufacturer's instructions for optimal results.
HER2 Scoring: Apply a well-defined scoring system to determine HER2 status. This typically involves classifying stns as negative -, weakly positive +, or strongly positive +++++ based on the intensity of stning and presence of membranous positivity.
Dual-Pathway Testing: For cases with equivocal IHC results, proceed with dual pathway testing using fluorescent in situ hybridization FISH. This method provides definitive evidence for HER2 amplification, which is crucial for decision-making regarding specific therapies.
Interpreting Results: Collaborate with pathologists experienced in HER2 analysis to ensure accurate and consistent interpretation of IHC and FISH results.
Patient Selection for Treatment: Based on the HER2 status confirmed by either IHC or FISH, tlor therapy options to maximize patient outcomes. HER2-positive patients may benefit from therapies such as trastuzumab-based regimens, while those with HER2-negative tumors might require alternative therapeutic strategies.
:
The comprehensive guidance in facilitate standardized and accurate HER2 expression assessment in gastric biopsy samples. By adhering to these recommations, clinicians can optimize patient care pathways, ensuring that gastric cancer patients receive the most appropriate and effective treatments based on their specific molecular profiles. This collaborative effort between researchers, healthcare providers, and industry partners is pivotal in advancing personalized medicine approaches for gastric cancer management.
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Comprehensive HER2 Testing Guidance for Gastric Cancer HER2 Expression in Gastric Biopsy Samples Management Standardized Procedure for Gastric Cancer Typing Tailoring Therapy Based on HER2 Status Dual Pathway Testing for Uncertain IHC Results Optimizing Patient Care through Molecular Profiling