RE: Concerning Dako's Her2 test kit

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From:Mark & Carrie Byrne <eire@teleport.com> (by way of histonet)
To:histonet <histonet@magicnet.net>
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hi sue,
hope i can answer your questions in a more satisfying way than your dako
rep.
first, while p185HER2 is found in normal breast.....it is present at a
minimal level.  antigen retrieval should always be used on all NBF fixed
specimens.
second, correlation between herceptest results and herceptin treatment
clinical outcome and prognostic indications.....the purpose of the test is
to screen patients for their expression level of p185HER2.  the reason being
patients with a high level of expression of HER2 TEND to respond better to
Herceptin treatment.  the purpose of herceptest is NOT to help give the
clinician an idea of what the patient's clinical outcome may be.  while
patients with high levels of p185HER2 expression TEND to have a poor
clinical outcome, this is not always true.  we had a patient a few weeks ago
that was screaming HER2 + and this was on tissue from 1985 (the patient was
still alive).
third, i believe the reason why there is a difference between herceptest
results and the clinical trial assay is that the clinical trial assay used
the herceptin aby itself (a HER2 aby, clone designation 4D5).  since it is a
monoclonal vs dako's poly there is bound to be some difference.
as to your final concern.....i can only say that it's up to your lab manager
(or however) to use their best judgement in choosing equipment. one should
never let sales techniques to sway your decision.
hope this helps, sorry it's so long.

carrie kyle-byrne
eire@teleport.com

ps.....the reason i know this stuff is because i worked on this project at
genentech several years ago.




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