Breast cancer is not a ‘one size fits all’ disease, and now women throughout the Rochester area will have quicker access to a test that measures the HER2/neu status of their tumor, enabling a better match to the correct treatment. The University of Rochester Medical Center (URMC) has the capability to test 500 cases a year for HER2 gene amplification in breast cancer, an important genetic biomarker, which is found in more than 15 percent of breast cancers.
HER2/neu, or Human Epidermal Growth Factor Receptor 2, regulates the normal growth of cells. When the HER2 gene is amplified, too many copies of the protein being present—2 million versus 20,000, for example—tumors are usually more aggressive and require specialized, targeted treatment. With testing facilities as far away as Calif., though, some local women in need of this specialized testing were apt to experience delays between diagnosis and knowing if this biomarker was indicated on their pathology report.
Since 2012 the URMC has been investing in the equipment, personnel and training to offer this new service throughout the region. The specific test is known as Fluorescence in Situ Hybridization (FISH). Accurate measurement of the HER2 gene status is important because many women can substantially benefit from several new treatments that target this gene, such as trastuzumab (Herceptin), lapatinib (Tykerb), pertuzumab (Perjeta) and T-DM1 (Kadcyla).
“In the past, breast cancer was viewed and treated as a single disease. This ‘one size fits all’ approach to treatment worked well for some patients and not at all for others. Today we are able to use information from molecular analysis of the breast tumor to help define targeted therapies to improve outcomes for some patients,” said David G. Hicks, M.D., director of Surgical Pathology at the URMC. “With HER2 testing available right in their back yard, women will be able to more quickly make decisions and be on their path to recovery.”
Hicks sits on the national committee responsible for updating guidelines that strengthen and clarify when and how to appropriately test for HER2 status. In 2010, he served in a similar capacity with the American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP), changing national guidelines on testing for estrogen and progesterone biomarkers in breast cancer.
“Successful breast cancer treatment in the future will rely more and more on the ability for oncologists and cancer researchers to fully understand the nuances of tumor biology, and apply correct therapies based on this knowledge,” said Jonathan Friedberg, M.D., director, Wilmot Cancer Center.