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National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current Cases of Gastrointestinal Cancer Friday, January 21, 2011 7:00 PM – 9:30 PM San Francisco, California. Moderator Neil Love, MD. Faculty. Charles D Blanke, MD David Cunningham, MD Steven A Curley, MD. - PowerPoint PPT PresentationTRANSCRIPT
Copyright © 2011 Research To Practice. All rights reserved.
Faculty
National GI Tumor Board
Clinical Investigators Provide Their Perspectives on Current Cases of Gastrointestinal Cancer
Friday, January 21, 20117:00 PM – 9:30 PM
San Francisco, California
ModeratorNeil Love, MD
Eileen M O’Reilly, MDEric Van Cutsem, MD, PhD Andrew X Zhu, MD, PhD
Charles D Blanke, MDDavid Cunningham, MDSteven A Curley, MD
Copyright © 2011 Research To Practice. All rights reserved.
Case presented by Dr Schwartz
• 76 yo man: PMH – NIDDM and CAD• 7/10: New anemia with melanotic stool Endoscopy =
tumor from distal esophagus to gastric cardia– Biopsy = PD adenoCA, HER2 IHC 1+ (FISH-negative)– PET/CT = GE tumor uptake + non-bulky mediastinal
nodes and ? liver lesion– Patient refused surgery
• 9/10: Cis/irinotecan GI bleeding resolved and ~ CT response completed XRT + wkly cis/irinotecan (11/10)
• Follow up endoscopy/scans pending
Copyright © 2011 Research To Practice. All rights reserved.
Copyright © 2011 Research To Practice. All rights reserved.
Case presented by Dr Schwartz
• 76 yo man: PMH – NIDDM and CAD• 7/10: New anemia with melanotic stool Endoscopy =
tumor from distal esophagus to gastric cardia– Biopsy = PD adenoCA, HER2 IHC 1+ (FISH-negative)– PET/CT = GE tumor uptake + non-bulky mediastinal
nodes and ? Liver lesion– Patient refused surgery
• 9/10: Cis/irinotecan GI bleeding resolved and ~ CT response completed XRT + wkly cis/irinotecan (11/10)
• Follow up endoscopy/scans pending
Copyright © 2011 Research To Practice. All rights reserved.
Copyright © 2011 Research To Practice. All rights reserved.
Faculty
National GI Tumor Board
Clinical Investigators Provide Their Perspectives on Current Cases of Gastrointestinal Cancer
Friday, January 21, 20117:00 PM – 9:30 PM
San Francisco, California
ModeratorNeil Love, MD
Eileen M O’Reilly, MDEric Van Cutsem, MD, PhD Andrew X Zhu, MD, PhD
Charles D Blanke, MDDavid Cunningham, MDSteven A Curley, MD
Copyright © 2011 Research To Practice. All rights reserved.
HER2 Diagnostics in Gastric Cancer — Guideline Validation and Development of Standardized Immunohistochemical TestingRüschoff J et al.
Virchows Arch 2010;457:299-307
Assessment of a HER2 Scoring System for Gastric Cancer: Results from a Validation StudyHofmann M et al.
Histopathology 2008;52:797-805
Copyright © 2011 Research To Practice. All rights reserved.
Gastric Cancer
Gastroesophageal Junction Cancer
Breast Cancer
Continuous Complete 360 Degree Membranous HER2 Staining
Incomplete Staining With Loss of Apical Membrane HER2 Expression
Marked Heterogeneity of HER2 Immunostaining
Comparison of HER2 IHC Slide Scoring in Gastric/GEJ and Breast Cancers
Courtesy of Jeffrey S Ross, MD
Copyright © 2011 Research To Practice. All rights reserved.
3%
1%
10%
3%
44%
27%12%
FISH positive/IHC 2+
FISH positive/IHC 3+
FISH positive/IHC 1+
FISH positive/IHC 0
FISH no result/IHC 3+
FISH positive/IHC no result
FISH negative/IHC 3+
ToGA: HER2 Status of Enrolled Patients
Bang YJ et al. Lancet 2010;376(9742):687-97.
Copyright © 2011 Research To Practice. All rights reserved.
Case presented by Dr Schwartz
• 76 yo man: PMH – NIDDM and CAD• 7/10: New anemia with melanotic stool Endoscopy =
tumor from distal esophagus to gastric cardia– Biopsy = PD adenoCA, HER2 IHC 1+ (FISH-negative)– PET/CT = GE tumor uptake + non-bulky mediastinal
nodes and ? Liver lesion– Patient refused surgery
• 9/10: Cis/irinotecan GI bleeding resolved and ~ CT response completed XRT + wkly cis/irinotecan (11/10)
• Follow up endoscopy/scans pending