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HER2 testing of gastro-oesophageal adenocarcinoma: a commentary and guidance document from the Association of Clinical Pathologists Molecular Pathology and Diagnostics Committee
  1. Newton A C S Wong1,
  2. Fernanda Amary2,
  3. Rachel Butler3,
  4. Richard Byers4,
  5. David Gonzalez5,
  6. Harry R Haynes6,
  7. Mohammad Ilyas7,
  8. Manuel Salto-Tellez8,
  9. Philippe Taniere9
  1. 1 Department of Cellular Pathology, Southmead Hospital, Bristol, UK
  2. 2 Department of Cellular and Molecular Pathology, Royal National Orthopaedic Hospital, Stanmore, UK
  3. 3 All Wales Genetics Laboratory, University Hospital of Wales, Cardiff, UK
  4. 4 Department of Histopathology, Central Manchester University Hospitals NHS Trust, Manchester, UK
  5. 5 Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Belfast, UK
  6. 6 Department of Cellular Pathology, University of Bristol and Southmead Hospital, Bristol, UK
  7. 7 Division of Cancer and Stem Cells and Nottingham Molecular Pathology Node, Queen’s Medical Centre, Nottingham, UK
  8. 8 Northern Ireland - Molecular Pathology Laboratory, Queen’s University, Belfast, UK
  9. 9 Department of Cellular Pathology, Queen Elizabeth Hospital, Birmingham, UK
  1. Correspondence to Dr Newton A C S Wong, Department of Cellular Pathology, Southmead Hospital, Bristol BS10 5NB, UK; Nacs.Wong{at}


The use of biologics targeted to the human epidermal growth factor receptor 2 (HER2) protein is the latest addition to the armamentarium used to fight advanced gastric or gastro-oesophageal junction adenocarcinoma. The decision to treat with the biologic trastuzumab is completely dependent on HER2 testing of tumour tissue. In 2017, the College of American Pathologists, American Society for Clinical Pathology and the American Society of Clinical Oncology jointly published guidelines for HER2 testing and clinical decision making in gastro-oesophageal adenocarcinoma. The Association of Clinical Pathologists Molecular Pathology and Diagnostics Committee has issued the following document as a commentary of these guidelines and, in parallel, to provide guidance on HER2 testing in National Health Service pathology departments within the UK. This guidance covers issues related to case selection, preanalytical aspects, analysis and interpretation of such HER2 testing.

  • adenocarcinoma stomach
  • oesophagus
  • HER2
  • immunohistochemistry
  • in-situ hybridisation
  • guidance
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  • Handling editor Runjan Chetty.

  • Contributors All the authors contributed to the writing of the document and approved the submitted version.

  • Funding MI has received sponsorship from Roche to support a Molecular Diagnostics Training School.

  • Competing interests NACSW has previously received antibodies and immunohistochemistry reagents from Roche Ventana for use in research projects. Other authors have no competing interests to declare.

  • Provenance and peer review Commissioned; externally peer reviewed.

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