it has become clear that a tailored approach to patient selection is required. There is increasing evidence that HER2 is an important biomarker in gastric and gastro esophageal junction tumors,21 analysis of HER2 status by immunohistochemistry and in situ hybridization techniques, using different scoring HA-1077 methods or assays, suggests that HER2 is overexpressed in B7 34% of gastric tumors.7,21 26 Results from the international, randomized, Phase III trastuzumab for GAstric cancer study demonstrated a survival benefit with trastuzumab plus chemotherapy in patients with HER2 positive locally advanced, recurrent and/or metastatic gastric or gastro esophageal junction tumors that overexpress HER2.1 Patients with high HER2 expressing tumors derived the greatest benefit from trastuzumab therapy.
HER2 positivity as defined in the trastuzumab for GAstric cancer study was immunohistochemistry Oxaliplatin Eloxatin 3þ and/or fluorescence in situ hybridizationpositive. On the basis of these findings, it is now recommended that all patients with gastric cancer should have their tumors tested for HER2 status Dienogest 65928-58-7 at the time of initial diagnosis. According to the European Medicines Agency license, patients with HER2 positive metastatic disease whose tumors are immunohistochemistry 3þ or immunohistochemistry 2þ/fluorescence in situ hybridization positive or immunohistochemistry 2þ/silver in situ hybridization positive are eligible for trastuzumab therapy.
27 Regulatory approval for trastuzumab was granted in October 2010 in the United States for Cyclophosphamide DNA/RNA synthesis inhibitor patients with metastatic adenocarcinoma of the stomach or gastro esophageal junction whose tumors were HER2 positive as determined using approved testing methods, and in Japan in 2011 for patients with inoperable advanced or recurrent HER2 overexpressing disease. As the expert panel met before American and Japanese approval, American and Japan specific recommendations are outside the scope of this paper. Given that the majority of patients present with advanced disease and that gastric cancer is a very rapidly progressing cancer, it is highly recommended that the turnaround time from the histological diagnosis of gastric cancer to reporting of the HER2 result should not exceed 5 working days. To achieve such fast turnaround times and to maintain high quality HER2 testing it is important to adopt a multidisciplinary approach, with testing performed in laboratories with training and experience in HER2 testing for gastric cancer.
Unique features of HER2 testing in gastric cancer The extensive experience of HER2 testing in breast cancer has highlighted the importance of optimizing HER2 testing and interpretation to ensure that patients who may derive benefit receive appropriate targeted therapy. cybernetics Gastric cancer exhibits unique immunostaining characteristics compared with breast cancer, including the high incidence of tumor heterogeneity in up to 30% of HER2 positive cases.7,28 Another key difference from breast cancer staining is that HER2 positive gastric carcinomas are usually of the gland forming intestinal type and may show incomplete, basolateral, or lateral staining inaddition to complete membrane staining and all these are considered as a positive result with immunohistochemistry. These differences have been taken into .
Related posts:
- Foretinib acts as a chemosensitizer to cisplatin on human gastric cancer cells
- HMBP Antibody DAC8 has become a effective anti-cancer therapy for several cancer
- STI-571 believe that the bias would be highly unlikely to account for the differences
- Lapatinib HER2 induced cell death within a dose- and time-dependent process