{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1361699994823898752.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.1038/modpathol.2011.198"}},{"identifier":{"@type":"URI","@value":"http://www.nature.com/articles/modpathol2011198.pdf"}},{"identifier":{"@type":"URI","@value":"http://www.nature.com/articles/modpathol2011198"}},{"identifier":{"@type":"URI","@value":"https://api.elsevier.com/content/article/PII:S089339522201612X?httpAccept=text/xml"}},{"identifier":{"@type":"URI","@value":"https://api.elsevier.com/content/article/PII:S089339522201612X?httpAccept=text/plain"}},{"identifier":{"@type":"PMID","@value":"22222640"}},{"identifier":{"@type":"HANDLE","@value":"2434/173681"}}],"dc:title":[{"@value":"HER2 testing in gastric cancer: a practical approach"}],"description":[{"notation":[{"@value":"Trastuzumab in combination with capecitabine or 5-fluorouracil and cisplatin is approved by the European Medicines Agency for the treatment of patients with human epidermal growth factor receptor 2 (HER2)-positive (immunohistochemistry 3+ or immunohistochemistry 2+/fluorescence in situ hybridization-positive or immunohistochemistry 2+/silver in situ hybridization-positive) metastatic adenocarcinoma of the stomach or gastro-esophageal junction. Approvals are underway in other countries, with recent approvals granted in the United States and Japan. Experience and data from trastuzumab use in breast cancer have highlighted the importance of quality HER2 testing and scoring to ensure accurate identification of patients eligible for treatment. HER2 testing in gastric cancer differs from testing in breast cancer due to inherent differences in tumor biology; gastric cancer more frequently shows HER2 heterogeneity (focal staining) and incomplete membrane staining. Consequently, gastric cancer-specific HER2 testing protocols have been developed and standardized and it is imperative that these recommendations be adhered to. Given the predictive value of HER2 protein levels with response in the trastuzumab for GAstric cancer study (ToGA), immunohistochemistry should be the initial testing methodology and fluorescence in situ hybridization or silver in situ hybridization should be used to retest immunohistochemistry 2+ samples. Wherever possible, bright-field methodologies should be used as these are considered to be superior to fluorescent methodologies at identifying heterogeneous staining. Specific training is required before embarking on HER2 testing in gastric cancer, irrespective of the experience of HER2 testing in breast cancer. This paper provides the most up-to-date practical guidance on HER2 testing and scoring in patients with gastric and gastro-esophageal junction cancer, as agreed by a panel of expert pathologists with extensive experience of HER2 testing particularly reflecting the European Medicines Agency-approved indication. It is anticipated that these recommendations should ensure accurate and consistent HER2 testing, which will allow appropriate selection of patients eligible for treatment with trastuzumab."}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1381699994823898754","@type":"Researcher","foaf:name":[{"@value":"Josef Rüschoff"}]},{"@id":"https://cir.nii.ac.jp/crid/1381699994823898756","@type":"Researcher","foaf:name":[{"@value":"Wedad Hanna"}]},{"@id":"https://cir.nii.ac.jp/crid/1381699994823898759","@type":"Researcher","foaf:name":[{"@value":"Michael Bilous"}]},{"@id":"https://cir.nii.ac.jp/crid/1381699994823898755","@type":"Researcher","foaf:name":[{"@value":"Manfred Hofmann"}]},{"@id":"https://cir.nii.ac.jp/crid/1381699994823898753","@type":"Researcher","foaf:name":[{"@value":"Robert Y Osamura"}]},{"@id":"https://cir.nii.ac.jp/crid/1381699994823898758","@type":"Researcher","foaf:name":[{"@value":"Frédérique Penault-Llorca"}]},{"@id":"https://cir.nii.ac.jp/crid/1381699994823898752","@type":"Researcher","foaf:name":[{"@value":"Marc van de Vijver"}]},{"@id":"https://cir.nii.ac.jp/crid/1381699994823898757","@type":"Researcher","foaf:name":[{"@value":"Giuseppe Viale"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"08933952"}],"prism:publicationName":[{"@value":"Modern Pathology"}],"dc:publisher":[{"@value":"Elsevier BV"}],"prism:publicationDate":"2012-05","prism:volume":"25","prism:number":"5","prism:startingPage":"637","prism:endingPage":"650"},"reviewed":"false","dcterms:accessRights":"http://purl.org/coar/access_right/c_abf2","dc:rights":["https://www.elsevier.com/tdm/userlicense/1.0/","https://www.elsevier.com/legal/tdmrep-license","http://www.elsevier.com/open-access/userlicense/1.0/"],"url":[{"@id":"http://www.nature.com/articles/modpathol2011198.pdf"},{"@id":"http://www.nature.com/articles/modpathol2011198"},{"@id":"https://api.elsevier.com/content/article/PII:S089339522201612X?httpAccept=text/xml"},{"@id":"https://api.elsevier.com/content/article/PII:S089339522201612X?httpAccept=text/plain"}],"createdAt":"2012-01-06","modifiedAt":"2025-10-12","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=Silver%20Staining","dc:title":"Silver Staining"},{"@id":"https://cir.nii.ac.jp/all?q=Esophageal%20Neoplasms","dc:title":"Esophageal Neoplasms"},{"@id":"https://cir.nii.ac.jp/all?q=Receptor,%20ErbB-2","dc:title":"Receptor, ErbB-2"},{"@id":"https://cir.nii.ac.jp/all?q=Antineoplastic%20Agents","dc:title":"Antineoplastic Agents"},{"@id":"https://cir.nii.ac.jp/all?q=Adenocarcinoma","dc:title":"Adenocarcinoma"},{"@id":"https://cir.nii.ac.jp/all?q=Trastuzumab","dc:title":"Trastuzumab"},{"@id":"https://cir.nii.ac.jp/all?q=Antibodies,%20Monoclonal,%20Humanized","dc:title":"Antibodies, Monoclonal, Humanized"},{"@id":"https://cir.nii.ac.jp/all?q=Immunohistochemistry","dc:title":"Immunohistochemistry"},{"@id":"https://cir.nii.ac.jp/all?q=Pathology%20and%20Forensic%20Medicine","dc:title":"Pathology and Forensic Medicine"},{"@id":"https://cir.nii.ac.jp/all?q=Stomach%20Neoplasms","dc:title":"Stomach Neoplasms"},{"@id":"https://cir.nii.ac.jp/all?q=Practice%20Guidelines%20as%20Topic","dc:title":"Practice Guidelines as Topic"},{"@id":"https://cir.nii.ac.jp/all?q=Humans","dc:title":"Humans"},{"@id":"https://cir.nii.ac.jp/all?q=Esophagogastric%20Junction","dc:title":"Esophagogastric Junction"},{"@id":"https://cir.nii.ac.jp/all?q=gastric%20cancer;%20guidance;%20HER2%20testing;%20immunohistochemistry;%20in%20situ%20hybridization;%20quality%20assurance;%20trastuzumab","dc:title":"gastric cancer; guidance; HER2 testing; immunohistochemistry; in situ hybridization; quality assurance; trastuzumab"},{"@id":"https://cir.nii.ac.jp/all?q=In%20Situ%20Hybridization","dc:title":"In Situ Hybridization"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1050001335950962560","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Intratumoral heterogeneous amplification of ERBB2 and subclonal genetic diversity in gastric cancers revealed by multiple ligation-dependent probe amplification and fluorescence in situ hybridization"}]},{"@id":"https://cir.nii.ac.jp/crid/1360004231240131584","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Interpretation of HER2 tests in gastric cancer: confirmation of interobserver differences and validation of a QA/QC educational program"}]},{"@id":"https://cir.nii.ac.jp/crid/1360004236369872512","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"MEK Inhibitor for Gastric Cancer with\n                    <i>MEK1</i>\n                    Gene Mutations"}]},{"@id":"https://cir.nii.ac.jp/crid/1360285710503161984","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Consistent absence of <scp>HER</scp>2 expression, regardless of <i><scp>HER</scp>2</i> amplification status, in neuroendocrine carcinomas of the stomach"}]},{"@id":"https://cir.nii.ac.jp/crid/1360565166808596352","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Overcoming chemoresistance of small-cell lung cancer through stepwise HER2-targeted antibody-dependent cell-mediated cytotoxicity and VEGF-targeted antiangiogenesis"}]},{"@id":"https://cir.nii.ac.jp/crid/1360567181151217152","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"HER2 Expression in Carcinomas of the True Cardia (Siewert Type II Esophagogastric Junction Carcinoma)"}]},{"@id":"https://cir.nii.ac.jp/crid/1360567181249642624","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"HER2 amplification detected in the circulating DNA of patients with gastric cancer: a retrospective pilot study"}]},{"@id":"https://cir.nii.ac.jp/crid/1360567186323324288","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Trastuzumab-Based Photoimmunotherapy Integrated with Viral HER2 Transduction Inhibits Peritoneally Disseminated HER2-Negative Cancer"}]},{"@id":"https://cir.nii.ac.jp/crid/1360567186803721984","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Targeting VEGFR2 with Ramucirumab strongly impacts effector/ activated regulatory T cells and CD8+ T cells in the tumor microenvironment"}]},{"@id":"https://cir.nii.ac.jp/crid/1360567187289597184","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Formalin fixation on HER-2 and PD-L1 expression in gastric cancer: A pilot analysis using the same surgical specimens with different fixation times"}]},{"@id":"https://cir.nii.ac.jp/crid/1360576118705765376","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Neuroendocrine carcinoma and mixed neuroendocrine‒non-neuroendocrine neoplasm of the stomach: a clinicopathological and exome sequencing study"}]},{"@id":"https://cir.nii.ac.jp/crid/1360576118771443200","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Histopathological features of HER2 overexpression in uterine carcinosarcoma: proposal for requirements in HER2 testing for targeted therapy"}]},{"@id":"https://cir.nii.ac.jp/crid/1360584340725269376","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Novel Biomarkers of Gastric Cancer: Current Research and Future Perspectives"}]},{"@id":"https://cir.nii.ac.jp/crid/1360869855565916544","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Molecular classification and intratumoral heterogeneity of gastric adenocarcinoma"}]},{"@id":"https://cir.nii.ac.jp/crid/1361131415817172736","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Cancer neovasculature-targeted near-infrared photoimmunotherapy (NIR-PIT) for gastric cancer: different mechanisms of phototoxicity compared to cell membrane-targeted NIR-PIT"}]},{"@id":"https://cir.nii.ac.jp/crid/1361137044788013696","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Trastuzumab deruxtecan (DS-8201a) in patients with advanced HER2-positive gastric cancer: a dose-expansion, phase 1 study"}]},{"@id":"https://cir.nii.ac.jp/crid/1520291856234183296","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Discovery and development of trastuzumab deruxtecan and safety management for patients with HER2-positive gastric cancer"}]}],"dataSourceIdentifier":[{"@type":"CROSSREF","@value":"10.1038/modpathol.2011.198"},{"@type":"OPENAIRE","@value":"doi_dedup___::bb19a5df369221b93b91900fc68b660d"},{"@type":"CROSSREF","@value":"10.1007/s00428-014-1567-9_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1158/1535-7163.mct-14-0429_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1111/his.12348_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1016/j.humpath.2013.11.004_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1016/s1470-2045(19)30088-9_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1038/srep02669_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1007/s00268-013-2256-6_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1007/s10120-014-0432-5_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1186/s40425-018-0403-1_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.12998/wjcc.v7.i4.419_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1016/j.humpath.2020.12.008_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1007/s00428-021-03017-5_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1007/s10120-021-01196-3_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.3390/jcm12144646_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1111/pin.13427_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1007/s10120-019-00988-y_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"},{"@type":"CROSSREF","@value":"10.1158/1535-7163.mct-15-0644_references_DOI_F5ZA698McH4PyZ01CraoK4ElTVI"}]}