Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.
Human epidermal growth factor receptor 2 (HER2) has been evaluated in breast
cancer patients to identify those most likely to benefit from herceptin-targeted
therapy. HER2 amplification, detected in 20-30% of invasive breast tumors, is
associated with reduced survival and metastasis. The most frequently used
technique for evaluating HER2 protein status as a routine procedure is
immunohistochemistry (IHC). HER2 copy number alterations have
also been evaluated by fluorescence in situ hybridization
(FISH) in moderate immunoexpression (IHC 2+) cases. An alternative procedure to
evaluate gene amplification is chromogenic in situ
hybridization (CISH), which has some advantages over FISH, including the
correlation between HER2 status and morphological features.
Other methodologies have also been used, such as silver-enhanced in
situ hybridization (SISH) and quantitative real-time RT-PCR, to
determine the number of HER2 gene copies and expression,
respectively. Here we will present a short and comprehensive review of the
current advances concerning HER2 evaluation in human breast
cancer.
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