[HER2 in selecting candidates to treatment with Trastuzumab. Determining HER2 status in breast cancer women.]

Cuadros Celorrio M, Villegas Portero R
Record ID 32008100067
Authors' objectives: The aim of this systematic review is determining the effectiveness (analytical validity, and clinical validity), clinical utility and cost of HER2 diagnostic tests (IHC vs. FISH) to correctly select breast cancer patients who are candidates to be treated with trastuzumab, for the Health National System to assess it.
Authors' results and conclusions: The cost-effectiveness ratio of different diagnostic strategies is 6,495.04Euros/ QALY in the case of diagnostic alone through IHC, 6,545.36Euros/QALY when FISH is realised alone, and 6,667.38Euros/QALY and 6,868.13Euros/QALY in the combined strategies, confirming through IHC+2 or IHC+3, respectively. The strategy to follow IHC alone dominates the combined strategies FISH, confirmatory for IHC+2 or IHC+2/3. The strategy to follow FISH alone is not dominated by IHC, costing more but it is also more effective that the former and entailing 11,641.20Euros per additional QALY. However, taking into account that the costs lost due to wrong diagnosis caused by low sensitivity and specificity of IHC, there results in an incremental cost of IHC of 5,995.08Euros with respects to FISH. Consequently, Fish results as the dominant strategy over the rest of alternatives.
Authors' recommendations: We recommend the following intervention tree:– Screening of HER2 in every breast-related case with IHC, employing diagnostic tests passed by FDA and/or EC or highly standardised and validated immunohystochemical protocols.
Authors' methods: Review
Project Status: Completed
Year Published: 2008
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Spain
MeSH Terms
  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Breast Neoplasms
Organisation Name: Andalusian Health Technology Assessment Area
Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309
Contact Name: aetsa.csalud@juntadeandalucia.es
Contact Email: aetsa.csalud@juntadeandalucia.es
Copyright: Andalusian Agency for Health Technology Assessment (AETSA)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.