Do you test your esophageal and gastric specimens for HER2 using IHC, FISH, or both?
We ask for IHC and reflex FISH for IHC score of 2. I find it most helpful and efficient when at least HER2, PD-L1, MMR are already done when patients come for medical oncology visits. When patients have advanced, unresectable disease, we have been requesting an expanded molecular panel that includes...
Per ASCO and College of American Pathology guidelines, we start with IHC. For tumors that are IHC 0/1+ (negative) or 3+ (positive), no further testing is indicated. For IHC 2+ tumors, we then proceed to FISH. IHC 2+ and FISH +ve tumors and IHC 3+ tumors are offered trastuzumab in the metastatic sett...
Our typical approach is to do Her2 IHC and FISH in all new esophageal/gastric adenocarcinoma cases. We also routinely test PDL1 (by CPS), MSI, and TMB. Most patients will also have tumor sent for genomic profiling. In that context, Her2 mutations and ERBB2 will usually be assessed, but our initial d...
With the advances in HER-2 directed therapies and availability of novel antibody drug conjugates (ADC), numerous issues are emerging that need to be addressed to optimize the HER-2 testing beyond what we have today. Assessment of low HER-2 expression now has become an important issue. The definition...