Cancer therapies are increasingly being tailored to fit the genetic profile of the patient, but new research suggests that human epidermal growth-factor receptor (HER)2 gene testing may be underused. A literature review found only scant information about the actual use of HER2 testing in clinical practice, suggesting that there are "important variations in testing practices and key gaps in knowledge about those practices."
The review was published online September 14 in Cancer.
It concludes that a large percentage of breast cancer patients who might benefit from trastuzumab (Herceptin) treatment appear not to be receiving it. Up to 66% of women eligible for HER2 testing had no documentation of a test in their health-insurance records, and up to 20% of patients receiving trastuzumab were not tested or had no documentation of a positive test.
The researchers also note that 20% of HER2 test results might be incorrect.
Wow, that's amazing, considering that Her2 testing is one of the best documented and studied cases of a companion diagnostic for a clinical drug. Perhaps as digital pathology becomes more widely adopted the use of Her2 testing will as well; it is a difficult screen to perform "manually" with conventional microscopy, and there are a number of FDA-approved image analysis solutions on the market.
(Including, of course, Aperio's Digital IHC solution; the membrane analysis used to quantify Her2 slides is shown at right, above...)
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