Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

HER2 testing in advanced gastric cancer – understanding and reducing variation in current practice to improve equity patient outcomes (#189)

Bianka D'souza 1 , John R Zalcberg 1 , Ahmad Aga 2 , Sumitra Ananda 3 4 , Khashayar Asadi 5 , Peter Bairstow 1 , Robert Blum 6 , Alex Boussioutas 7 , Stephen Brown 8 , Wendy Brown 7 , Richard Chen 9 , Cuong Duong 4 , Stephen Fox 4 , Marnie Graco 5 , Hugh Greene 1 , Chris Hair 10 , Sayed Hassen 11 , Andrew Haydon 7 , Michael Hii 12 , Harpreet Kaur 1 , Lara Lipton 9 , Sim Yee Ong 11 , Cameron Snell 4 , Peter Tagkalidis 7 13 14 , Bassam Tawfik 15 , Stefan Uzelac 1 , Sharon Wallace 16 , Rachel Wong 11 , Liane Ioannou 1
  1. Monash University, Melbourne, VICTORIA, Australia
  2. Melbourne Pathology, Melbourne, VICTORIA, Australia
  3. Epworth HealthCare, Melbourne, VICTORIA, Australia
  4. Peter MacCallum Cancer Centre, Melbourne, VICTORIA, Australia
  5. Austin Health, Melbourne, VICTORIA, Australia
  6. Bendigo Health, Bendigo, VICTORIA, Australia
  7. Alfred Health, Melbourne, VICTORIA, Australia
  8. Grampians Health, Ballarat, VICTORIA, Australia
  9. Cabrini Health, Melbourne, VICTORIA, Australia
  10. Epworth HealthCare, Geelong, VICTORIA, Australia
  11. Eastern Health, Melbourne, VICTORIA, Australia
  12. St Vincent's Hospital Melbourne, Melbourne, VICTORIA, Australia
  13. Melbourne Health, Melbourne, VICTORIA, Australia
  14. Western Health, Melbourne, VICTORIA, Australia
  15. Melbourne Pathology, Geelong, VICTORIA, Australia
  16. Dorevitch Pathology, Ballarat, VICTORIA, Australia

Despite evidence-based guidelines stating that testing for HER2 status should be performed in all patients with advanced or recurrent gastric cancer, and that such testing should be in accordance with standardised diagnostic and pathological testing algorithms, there is a need to better understand this in practice to enable equity in patient outcomes.


The HER2 Project aims to determine the extent to which tumours from patients with advanced or recurrent gastric cancer across major centres in Victoria are being adequately assessed for overexpression and/or amplification of HER2; and to determine the extent that standardised testing algorithms are being used to test for HER2 status.


This is a retrospective cohort study that will be split into three phases: Phase I – Data Extraction, Phase II – Pathology Review and Phase III – Qualitative Sub-study. For Phase I and II, this project plans to leverage data collected for the Upper Gastrointestinal Cancer Registry (UGICR) to understand current practices of testing for HER2 status in patients with advanced gastric cancer across twelve hospitals in Victoria. For Phase III, stakeholders involved the various stages of HER2 testing will be invited to participated in structured interviews, to better understand current practice in Australia.


This mixed methods approach incorporating clinical quality registry data may provide us with insight into current HER2 testing practices in Australia, as well as suggestions for how to improve future testing standards. The implication of any failure to correctly diagnose HER2 positive tumours is that these patients may miss the opportunity to receive targeted drug therapy, which is known to improve response to treatment as well as prolong overall survival.