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Comparison of HER2 Assays

Objectives
  • To compare the results from four FDA-approved assay methods and two other immunohistochemical assays used to test for HER2 status

Methods
  • 117 breast tumor specimens, previously molecularly characterized for HER2 gene amplification and protein overexpression, were evaluated for HER2 gene amplification by FISH with the PathVysionTM assay and Inform® HER2/neu assay.

  • The same specimens were also evaluated for HER2 protein overexpression by IHC with the HercepTestTM assay, PathwayTM HER2 assay, R60 polyclonal antibody and 10H8 monoclonal antibody.

Results

Authors’ Conclusions
“Our findings demonstrated that the FISH assays have higher sensitivity and higher accuracy and more often correctly identify altered HER-2/neu status (amplification/overexpression) in previously molecularly characterized specimens than did the FDA-approved immunhistochemistry assays interpreted manually.”

Research Leader Commentary

This analysis actually compared several different reagents. Press and colleagues used a polyclonal antibody and compared it to some monoclonal antibodies, including 10H8 (not yet widely used and not FDA-approved), Ventana’s CB-11, and the Dako HercepTestTM. I caution that one can alter the sensitivity or specificity of any reagent, so a ranking that’s slightly (2% or 3%) better should be taken with a grain of salt. It sounds like the antibodies are pretty much in same ballpark.

Ann D Thor, MD

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CME Information
Editor’s Note:
Getting It Right
Faculty

Concordance Between Local and Central Laboratory HER2 Testing
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Comparison of HER2 Assays
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Concordance of HER2 Status Between Primary and Metastatic Lesions
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HER2 Status and Response to Trastuzumab
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College of American Pathologists
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