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Type: Journal article
Title: Gastric HER2 Testing Study (GaTHER): An Evaluation of Gastric/Gastroesophageal Junction Cancer Testing Accuracy in Australia
Author: Fox, S.
Kumarasinghe, M.
Armes, J.
Bilous, M.
Cummings, M.
Farshid, G.
Fitzpatrick, N.
Francis, G.
McCloud, P.
Raymond, W.
Morey, A.
Citation: American Journal of Surgical Pathology, 2012; 36(4):577-582
Publisher: Lippincott Williams & Wilkins
Issue Date: 2012
ISSN: 0147-5185
Statement of
Stephen B. Fox, Marian Priyanthi Kumarasinghe, Jane E. Armes, Michael Bilous, Margaret C. Cummings, Gelareh Farshid, Nicole Fitzpatrick, Philip I. McCloud, Wendy Ann Raymond and Adrienne Morey
Abstract: rastuzumab provides a survival benefit in patients with human epidermal growth factor receptor 2 (HER2)-amplified/overexpressed advanced gastric and gastroesophageal junction cancers (GC/GJCs). However, the optimal method for testing is unclear. The aim of this study was to assess interlaboratory agreement on HER2 scoring in GC/GJC to aid the development of a robust testing algorithm for diagnostic practice in Australia. Nine laboratories assessed the HER2 status of 100 GC/GJC tissue samples by immunohistochemistry (IHC) and in situ hybridization (ISH) [chromogenic (CISH) or silver (SISH)] using both HER2 copy number and HER2:chr17 (chromosome 17) ratio. Results were compared with reference fluorescence ISH (FISH). Interlaboratory agreement on IHC3+ scoring was good ([kappa]=0.76), and there was good/very good agreement between IHC (positivity defined as IHC3+) and ISH when HER2 copy number was used ([kappa]=0.72 to 0.87). Agreement on CISH/SISH scoring was good/very good when HER2 copy number was used ([kappa]=0.68 to 0.86), and agreement between CISH/SISH and FISH using HER2 copy number was very good ([kappa]=0.88 to 0.91). Agreement was reduced when HER2:chr17 ratio was used. The good agreement for HER2 copy number determined by bright-field ISH suggests that this is the optimal method for testing in GC/GJC cases. An IHC3+ score was strongly predictive of a positive ISH result, although agreement for all IHC scores was only moderate, suggesting that IHC triage before ISH testing would be the most cost-effective strategy. However, because of the unique features of GC/GJC samples and the difficulty of ensuring consistent HER2 staining in the community setting, it is recommended that HER2 status in advanced GC/GJC be determined by both IHC and ISH in the same laboratory.
Keywords: HER2; immunohistochemistry; in situ hybridization; gastric cancer; trastuzumab
Rights: © 2012 by Lippincott Williams & Wilkins
RMID: 0020118228
DOI: 10.1097/PAS.0b013e318244adbb
Appears in Collections:Pathology publications

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