Breast Cancer remains the only major cancer in which specific treatment is routinely determined by specific predictive variables. Presently, commercial predictive technologies is divided into four important platforms, immunohistochemical IHC testing, fluorescent in situ hybridization techniques FISH, genomic analysis and quantitative immunofluorescence. Tests based on immunohistochemistry IHC and fluorescent in situ hybridization techniques FISH currently dominate the breast cancer diagnostic testing landscape. In this context, both of these techniques are most often utilized to rate HER-2 or hormone-receptor status. Tests of evaluation results allow clinicians to correctly select patients likely to benefit from the corresponding treatment. This industry is now dominated by large, established businesses offering FDA approved products.
Currently genomic assays are most often used to Determine cancer recurrence and relapse, although expansion into predictive assays is penalized. These city x ray tilak nagar based assays are now the domain of small and mid-level businesses. Tests with fluorescently tagged antibodies to quantify amounts of proteins linked to specific drug action have recently entered the marketplace. These evaluations can help doctors determine which drugs are most likely to be successful for a particular patient. IHC is the process of localizing proteins in cells of a tissue section using the principle of antibody binding to particular antigens Generally, IHC tests have FDA approval and are offered in the comparatively low budget of $200 – $400. These evaluations are performed regularly in many pathology labs. The prognostic value of IHC is well known for HER-2 and Estrogen Receptor ER, but isn’t established as a predictor of the efficacy of cytotoxic drugs.
Moreover, there has been substantial business concern within the reproducibility of HER-2 /neu detection from lab to lab, that affects the validity of the test. For examples, the American Society of Clinical Oncology and the College of American Pathologists characterize the interpretation of IHC results as somewhat arbitrary and discovered that results from as many as 15 – 20% of the assays could be incorrect. FISH is a cytogenetic technique that can be used to detect and localize the presence of specific DNA sequences on chromosomes. This technology is often utilized together with IHC to ascertain HER-2 expression and has recently been employed to hormone receptor status. Just like immunohistochemistry, these tests are performed regularly in many pathology labs. The advertised technologies again normally have FDA approval and market at the $400 – $600 range. Numerous retrospective clinical trials have indicated that FISH is more accurate in predicting a positive benefit from Herceptin therapy. However, certain drawbacks are also connected with FISH analysis.
