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CAP, ASCP, ASCO Invite Public Comment on Gastric Cancer Guideline
  • USA - English


News provided by

American Society for Clinical Pathology

Dec 08, 2015, 13:00 ET

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This guideline is important for ensuring that gastric and esophageal adenocarcinomas are appropriately tested for determining patient eligibility for HER2 targeted therapy.

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Chicago, IL (PRWEB) December 08, 2015 -- Dec. 8, 2015—The College of American Pathologists (CAP), the American Society for Clinical Pathology (ASCP), and the American Society of Clinical Oncology (ASCO) today released a draft of a clinical practice guideline on the use of human epidermal growth factor receptor 2 (HER2) testing for patients with gastric or gastroesophageal cancer. This evidence-based guideline will help establish standard HER2 testing, improve the accuracy of the test interpretation, guide HER2-targeted therapies and provide personalized care for these patients. The DRAFT RECOMMENDATIONS for the “CAP-ASCP-ASCO HER2 Testing in Gastroesophageal Adenocarcinoma Guideline” are now available for public comment through Jan. 11, 2016.

All stakeholders, including oncologists, pathologists, gastroenterologists, nurses, allied health professionals, hospital or laboratory administrators, patient advocacy group representatives, and patients, are encouraged to provide feedback on these draft recommendations.

The co-chairs, one each from the three organizations CAP, ASCP and ASCO, sought the input of expert panelists chosen as specialists in a variety of disciplines, including pathologists and oncologists as well as a gastroenterologist and a patient advocate, to draft the guidance document. The multi-disciplinary perspective has resulted in a thorough set of draft recommendations that streamline processes and contribute to improving patient outcomes. As such, it is recommended that HER2 status should be included in the diagnostic protocol for Gastroesophageal Adenocarcinoma.

“This will be the first comprehensive guideline for HER2 testing in gastroesophageal adenocarcinoma produced by these three organizations with national and international expert input after an exhaustive literature review,” said Angela N. Bartley, MD, FCAP, a molecular genetic and gastrointestinal pathologist at St. Joseph Mercy Health System in Ann Arbor, Mich., representing the CAP. "We would like the public to comment on the recommendations with the knowledge that the final recommendations will be included in a peer-reviewed manuscript with the rationale and evidence. The comments gathered from the public will help define the discussion in the final manuscript.”

Approximately 95 percent of gastric cancers are adenocarcinomas arising from the glandular tissue of the stomach lining. The monoclonal antibody trastuzumab (brand name Herceptin) has been shown to improve the survival of patients with advanced gastric cancer. The addition of trastuzumab to standard chemotherapy has helped patients with advanced gastric cancer whose tumors overexpress HER2 live longer. According to related trial findings, approximately 22 percent of gastric and gastroesophageal junction cancers overexpress HER2. Accordingly, it is recommended that testing for HER2 status should be included in the diagnostic protocol for metastatic or locally advanced gastric cancer.

However, there is no evidence-based ASCO/CAP-approved HER2 testing guideline for gastric cancer. Moreover, HER2 scoring criteria for gastric cancer differ from scoring criteria that ASCO/CAP guidelines established for breast cancer. In fact, the “Trastuzumab for Gastric Cancer,” or ToGA trial found that if only the HER2 breast cancer testing algorithm were used for gastric cancers, one in four patients treatment-eligible could be missed.

“The recommendations have been separated for those who treat the patient and for those who are involved in testing,” said Jaffer A. Ajani, MD, a medical oncologist at the MD Anderson Cancer Center in Houston, who represents ASCO for this guideline. “Once these guidelines are established and published, availability of novel information will allow us to keep refining them. Our goal is that the appropriate audiences from around the globe will embrace (and use) these guidelines.”

“This guideline is important for ensuring that gastric and esophageal adenocarcinomas are appropriately tested for determining patient eligibility for HER2 targeted therapy,” said Kay Washington, MD, PhD, FASCP, a pathologist at Vanderbilt University Medical Center, Nashville, Tenn., who represents ASCP. “It will help improve patient care by ensuring that only patients likely to benefit from HER2-directed therapy are treated with trastuzumab.”

These draft recommendations have been developed consistent with the Institute of Medicine’s evidence-based clinical practice guideline development recommendations. The final guidance document is targeted for publication in the first half of 2016.

Editor’s Note:
The draft recommendations and references provided here represent time-limited information and are not to be distributed, used, or considered as an accurate representation of the group’s work product(s) after Jan. 11, 2016.

About CAP
As the leading organization with more than 18,000 board-certified pathologists, the College of American Pathologists (CAP) serves patients, pathologists, and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine worldwide. The CAP’s Laboratory Improvement Programs, initiated 65 years ago, currently has customers in more than 100 countries, accrediting 7,600 laboratories and providing proficiency testing to 20,000 laboratories worldwide. Find more information about the CAP at http://www.CAP.org. Follow CAP on Twitter at@PATHOLOGISTS.

About ASCO
Founded in 1964, the American Society of Clinical Oncology (ASCO) is the world's leading professional organization representing physicians who care for people with cancer. With nearly 40,000 members, ASCO is committed to improving cancer care through scientific meetings, educational programs and peer-reviewed journals. ASCO is supported by its affiliate organization, the Conquer Cancer Foundation, which funds ground-breaking research and programs that make a tangible difference in the lives of people with cancer. For ASCO information and resources, visit http://www.asco.org. Patient-oriented cancer information is available at http://www.cancer.net.

About ASCP
Founded in 1922 in Chicago, ASCP is a medical professional society with more than 100,000 member board-certified anatomic and clinical pathologists, pathology residents and fellows, laboratory professionals, and students. ASCP provides excellence in education, certification, and advocacy on behalf of patients, pathologists, and laboratory professionals. To learn more, visit http://www.ascp.org. Follow us on Twitter at http://www.twitter.com/ascp_chicago and connect with us on Facebook at http://www.facebook.com/ASCP.Chicago.

# # #

Pam Flores, American Society for Clinical Pathology, +1 7732189260, [email protected]

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