Published in:
Open Access
01-09-2013 | Proceedings
Is HER2 amplification predictable by digital immunohistochemistry?
Authors:
Tamás Micsik, Gábor Kiszler, Daniel Szabó, László Krecsák, Tibor Krenács, Béla Molnár
Published in:
Diagnostic Pathology
|
Special Issue 1/2013
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Excerpt
In the last decade anti-HER2 treatment became one of the best examples for targeted treatment. Since the aggressive behavior of HER2-positive breast cancers could have been successfully reduced by trastuzumab therapy, HER2 positive breast cancers recently show improving prognosis. According to a four-tiered classification of international clinical guidelines, cases with strong and complete staining (IHC 3+) with anti-HER2 antibodies are eligible for trastuzumab therapy. The cases with complete, but moderate anti-HER2 stainings (2+ or equivocal) should be further investigated with (F)ISH-technique to determine HER2-amplification [
1]. Negative and IHC 3+ cases are easy to interpret semi-quantitatively on routine immunohistology, it is hard to conclude on the equivocal cases, sill, anti-HER2 therapy is indicated upon the predictive pathology report of HER2-expression and interobserver variability of IHC-interpretation still remains rather high [
2]. Furthermore, the response rate of patients to the rather expensive tratuzumab therapy that might be accompanied by side effects is still only about 50% [
3]. The rapidly developing digital pathology solutions have promised better ways of archiving, documenting and standardizing immunohistochemistry including image analysis of HER2 detection to improve the efficacy of targeted anti-HER2 therapy [
4]. …