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  • HER2 IHC reporting updates for gynecologic cancers
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HER2 IHC reporting updates for gynecologic cancers

 
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In December 2024, the College of American Pathologists (CAP) released an updated Template for Reporting Results of Biomarker Testing of Specimens from Patients with Carcinoma of Gynecologic Origin.1 This update establishes HER2 IHC as a routine biomarker test across gynecologic cancers.1

Key updates:

Addition of ovarian and cervical HER2 guidance:

The template now includes fields for reporting HER2 IHC results in ovarian and cervical cancers.1

  • The template’s definition of HER2
    IHC 3+
    for these tumors is strong, complete, basolateral or lateral membrane staining in ≥10% of tumor cells.1
  • The template also includes different scoring criteria for biopsy specimens versus surgical specimens. See graphic below for biopsy criteria.1

Expansion of endometrial HER2 scoring guidance:

Previously limited to endometrial serous tumors, the template update expanded HER2 IHC reporting guidance to all endometrial carcinomas, irrespective of histology.1

  • The template outlines two HER2 scoring systems for endometrial tumors. The membrane staining threshold for HER2 IHC 3+ is either ≥10% or >30%, depending on the scoring system.1 Consult with your oncologist to clarify the clinical objective, which will guide the appropriate selection of scoring system for endometrial tumors. See graphic below for detail on scoring criteria for endometrial tumors.
HER2 IHC 3+ scoring criteria for gynecologic specimens1
HER2 IHC 3+ Scoring Criteria for Gynecologic SpecimensHER2 IHC 3+ Scoring Criteria for Gynecologic Specimens

HER2 IHC scoring criteria:

The CAP template’s criteria for ovarian, cervical and endometrial include lateral and basolateral staining in their definitions of HER2-positive (IHC 3+).1 Unlike the patterns seen in breast carcinoma, HER2 staining in endometrial carcinoma is often lateral or basolateral and spares the
apical portion of the tumor cells.1

Reporting considerations:

CAP suggests reporting the percentage of tumor cells with strong complete or basolateral/lateral membrane staining, alongside the overall HER2 IHC result, due to potential rescoring needs.1

See the updated CAP Gynecologic Biomarkers reporting template for full
scoring criteria

View latest CAP reporting template

For more guidance on HER2 IHC testing in gynecologic cancers, view the resources below.

CAP, College of American Pathologists; HER2, human epidermal growth factor receptor 2; IHC, immunohistochemistry.

1. CAP. Template for Reporting Results of Biomarker Testing of Specimens from Patients with Carcinoma of Gynecologic Origin. Version 1.2.0.0. Available at: https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocol-templates. Accessed: February 2025.

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