Overview
Strategies for Improving ERBB2 (HER2) Testing in NSCLC Within Community Settings
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The pace at which targetable tumor-specific molecular alterations have been identified over the past decade have ushered in an era of precision oncology, yielding significant insights into the diversity of cancer, offering diagnostic and prognostic benefits, and guiding therapy selection. Indeed, guidelines emphasize that comprehensive biomarker testing should be conducted to identify actionable mutations in non-small-cell lung cancer (NSCLC), including ALK, EGFR, KRAS, MET, RET, and ERBB2 (HER2). These tests guide the selection of targeted therapies that can inhibit oncogenic pathways directly implicated in tumor growth and progression. However, comprehensive molecular testing continues to be underused, especially in community hospital settings. Underlying reasons are many and varied, and include lack of clinical knowledge, lack of multidisciplinary support in the interpretation of test results, shortcomings in tissue samples, lack of access to tests, reimbursement challenges, and turnaround times.
Quality improvement (QI) programs are well suited to facilitate adoption of system-level solutions to improve guideline recommended testing of patients with NSCLC, including in patients with HER2 (ERBB2) mutations; To improve guideline recommended testing of patients with NSCLC, including in patients with HER2 (ERBB2) mutations, implementation-focused educational programs facilitating system- and process-related changes along with formalized training cascades are key to mitigating barriers. This interactive practice guide offers interventions for both team training and infrastructure building in a cost effective and high impact way. Learners can identify solutions most relevant to their scope of practice and areas of need.
Don’t delay! Start improving your NSCLC biomarker testing to optimize treatment processes and practices now!
This activity is intended for multidisciplinary providers treating patients with NSCLC in the community cancer setting including thoracic oncologists, thoracic surgeons, medical oncologists, molecular pathologists, pulmonologists, oncology pharmacists, clinical pharmacists, patient navigators, tissue navigators, and other members of the multidisciplinary team.
Upon completion of this activity, learners will be able to:
• Assess current NSCLC biomarker testing practices to confirm compliance with the latest guideline recommendations for a broad multi-panel approach
• Develop strategies to mitigate challenges and barriers to standardizing ERBB2 (HER2) testing in all patients with advanced NSCLC
• Establish multidisciplinary frameworks to interpret biomarker test findings prior to initiating first-line treatment and reassess again when initiating second-line treatment
• Assess current NSCLC biomarker testing practices to confirm compliance with the latest guideline recommendations for a broad multi-panel approach
• Develop strategies to mitigate challenges and barriers to standardizing ERBB2 (HER2) testing in all patients with advanced NSCLC
• Establish multidisciplinary frameworks to interpret biomarker test findings prior to initiating first-line treatment and reassess again when initiating second-line treatment
Standardizing ERBB2/HER2 Testing Strategies
• Overview of ERBB2/HER2 testing
• Guidance for ERBB2/HER2 testing in advanced NSCLC
• Diagnostic assay and biomarker selection
• Strategies for overcoming barriers
Specimen Acquisition and Processing
• Optimal sample collection and testing
• Sample procurement practices and techniques
• Tumor biology considerations
• Overcoming barriers
Interpreting Findings and Incorporating into Regular Practice
• Streamlining data collection and reporting between lab and EHR
• Molecular genomic report interpretation
• Identifying clinically relevant targets
• Weighing levels of evidence
• Patient selection
• Overcoming barriers
Provided by University of Chicago Pritzker School of Medicine and the Academy for Continued Healthcare Learning (ACHL).
Supported by an educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.
https://www.improvensclctesting.org/
Christine Bestvina, MD
Assistant Professor of Medicine
Section of Hematology/Oncology
University of Chicago Medicine
Chicago, IL
Assistant Professor of Medicine
Section of Hematology/Oncology
University of Chicago Medicine
Chicago, IL
Melissa Tjota, MD, PhD
Assistant Professor
Department of Pathology
University of Chicago Medicine
Chicago, IL
As a provider accredited by the ACCME, The University of Chicago Pritzker School of Medicine asks everyone in a position to control the content of an education activity to disclose all financial relationships with any ineligible companies. This includes any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. Financial relationships are relevant if a financial relationship, in any amount, exists between the person in control of content and an ineligible company during the past 24 months, and the content of the education is related to the products of an ineligible company with whom the person has a financial relationship. Mechanisms are in place to identify and mitigate any relevant financial relationships prior to the start of the activity.
Additionally, The University of Chicago Pritzker School of Medicine requires Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration at first mention and where appropriate in the content.
The following financial relationships have been provided:
Christine Bestvina, MD –
Advisory Boards/Consultant: AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Catalyst, Daiichi Sankyo, EMD Serono, Genentech, Gilead, Guardant, Jazz, Johnson & Johnson, Lilly, Mirati, Novartis, Pfizer, Summit Therapeutics, Tempus, Turning Point Therapeutics.
Grants/Research Support: AstraZeneca, Bristol Myers Squibb
Melissa Tjota, MD, PhD –
No financial relationships to disclose.
Kashyap Padmaraju, PharmD, BCPS (Peer Reviewer) –
No financial relationships to disclose.
The University of Chicago Pritzker School of Medicine, ACHL staff members and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose. All of the relevant financial relationships listed for these individuals have been mitigated.
The content for this activity was developed independently of any ineligible company. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor(s).
This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.
This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL and The University of Chicago require the speaker to disclose that a product is not labeled for the use under discussion.
Discussion of scientific information on unapproved uses (SIUU), off-label, investigational, or experimental drug/device use: trastuzumab emtansine is not approved for the treatment of ERBB2-altered NSCLC.
This activity will take approximately 150 minutes to complete. To receive credit, learners are required to complete the pretest, view the online activity, and complete the posttest and evaluation. To receive credit, 66% must be achieved on the posttest. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.
Partial credit may not be awarded for CPE credit; participation in the complete activity is required to receive credit. CPE credit will be submitted to CPE Monitor® on the first business day of each month.
The University of Chicago Pritzker School of Medicine designates this enduring material for a maximum of 2.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physician assistants, nurse practitioners, and nurses may participate in this educational activity and earn a certificate of completion as AAPA, AANP, and ANCC accept AMA PRA Category 1 Credits™ through their reciprocity agreements.
Completion of this activity, including the pretest, posttest, and follow-up assessments, qualifies as a medium weight MIPS improvement activity under MACRA and can be claimed as completion of IA_PSPA 28 of an Accredited Safety or Quality Improvement Program in the Quality Payment Program. Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website. You will receive additional information after completing the activity and receiving your certificate via email.
This activity has been approved for 2.5 contact hours.
ACPE Universal Activity Number: 0396-0000-26-003-H01-P
Activity Type: Application
Release Date: April 1, 2026
Expiration Date: April 1, 2027
