When do you recommend incorporating HER2 testing into the diagnostic pathway for tumor types where HER2 overexpression is not commonly assessed?
Will you test HER2 IHC upfront for all? Or wait until later in the disease course, once a patient has exhausted other standard of care options?
Answer from: Medical Oncologist at Academic Institution
I would recommend HER2 IHC testing at the time of advanced cancer diagnosis or at the next therapy change, whenever HER2-targeted therapy would be considered in the treatment course.
Answer from: Medical Oncologist at Community Practice
For histologies not routinely assessed for HER2, I do not recommend universal upfront IHC at diagnosis. A pragmatic approach is reflex IHC at the time of advanced progression, when therapeutic impact is highest. In select cases—aggressive biology or early relapse after perioperative therapy&md...
Answer from: Medical Oncologist at Academic Institution
I agree with this approach. I recommend testing tissue for HER2 IHC early on in the course of metastatic disease for patients with advanced urothelial cancer. I often even use archival samples from radical cystectomies which are fairly concordant. Based on recently published data in a large (>200...