Transcription

• Elizabeth McMahon

  Coming up: A new webinar will help you brush up your skills in lung pathology … plus, it’s order renewal time. The C-A-P’s 2026 proficiency testing programs are ready for your lab and we’re previewing the offerings in anatomic pathology, including breast cancer. Welcome to the Path News Network Daily Edition from the College of American Pathologists. I'm Elizabeth McMahon. It's Wednesday, October 22nd. And here are the headlines. If you're a surgical pathologist, staying current on disease entities, diagnosis techniques, and pitfalls can be a challenge. The CAP is here to help. If you're looking to sharpen your skills in lung pathology, sign up for our interactive live-streamed webinar on November 12th. Expert faculty will share digitally scanned slide images and focus on a practical, modern approach to diagnosis. One CME credit is available for the session. Imagine a pathology conference where all of the research authors and presenters are AI bots. Sound far-fetched? Though most scientific conferences ban machines from being authors or speakers, tune in at 10.30 a.m. Central today for the online event Agents for Science 2025. The group is experimenting with using AI as primary contributors and humans as attendees. Co-organizers Stanford University and Together AI hope the conference will produce data on the quality of AI research and the types of mistakes bots can make. AI reviewers received more than 300 research submissions for the conference and accepted 48. The link is in the show notes. Amid the flood of pink ribbons in October, the role of pathology in treating breast cancer can be easily overlooked. Starting in the early labs of Rudolf Virchow, and William Halsted, a new article in Pathology magazine, takes a look back at the research and breakthroughs that led to the dawn of precision oncology in breast cancer. From early tumor grading to immunochemistry and HER2 testing, the article outlines the profession's pivotal place in the innovations that have led to improved outcomes for patients. And finally, the CAP has launched a host of new proficiency testing programs for 2026, including first-of-their-kind offerings. The Path News Network will highlight several in the coming days, starting with programs in anatomic pathology. I spoke with Dr. Emily Meserve, Vice Chair of the CAP's Immunohistochemistry Committee, about new programs in this area, including those for breast and gastric cancers. Thanks for joining me, Dr. Meserve. I wanted to start with gastric and pan tumor HER2 testing and HER2 and ER testing. Why are these new proficiency testing programs important and how do they differ from each other? What are the clinical and scientific needs they address?

• Dr. Emily Meserve

  So the question is about two new educational programs. These focus on the interpretation of immunistochemical tests, evaluating the expression of estrogen receptor protein, and HER2 protein in different tumor types. These tests are critically important because the results are used to predict likelihood. response to specific therapies and therefore which drugs cancer patients may be eligible to receive. So the clinical and scientific need, historically the college has offered proficiency testing products to help laboratories confirm that their ER and HER2 IHC tests are performing well, but IHC involves both technical and technical variables and variables related to how pathologists interpret the IHC slides. So the committee wanted to develop some educational programs that can focus on just the interpretation part of the test and support pathologists in continuing to develop their skills. So we are affectionately calling the educational program for breast cancer cases that use ER and HER2 IHC and the ASCO-CAP breast guidelines. We're calling it HER2 and ER interpretation. That's what that stands for. And then, the gastric and pan HER2 product will use gastric and a variety of other tumor types using gastric interpretation criteria, and we're calling that one GPH, or gastric and pan HER2. And we're hoping that these will be educational tools that pathologists can use to improve their interpretation performance.

• Elizabeth McMahon

  There's also a new PDL tumor proportion score program available. Tell me more about how this test is used, what it measures, and how it's used clinically.

• Dr. Emily Meserve

  The PD-L1 TPS program is very similar to HERI and GPH in that it's interrogating a specific test that is used clinically to direct targeted therapies for patients with cancer. The PD-L1 TPS program is targeted towards lung cancer because that's where tumor proportion score is used. And so the products are very similar. We are going to offer cases that have been reviewed by the IHC committee to obtain consensus opinion on the interpretation and put those out for people who subscribe to these programs to review and compare their responses to.

• Elizabeth McMahon

  Can you talk a little about how this enhances lab quality and accuracy?

• Dr. Emily Meserve

  Laboratories in general often or should most of them have quality management programs. A component of a quality management program so-called is under the auspices of assessments. meaning how does the laboratory on an ongoing basis compare its performance to another standard. That can come in a variety of different flavors, proficiency testing being the most widely known and commonly used. But there aren't a lot of products out there that help pathologists compare their interpretations with a reference standard. So we see this fitting into that part of a lab's quality management plan as just another option. It's not a graded or a monitored situation like proficiency testing can be. It's just educational, just another tool in the toolbox, so to speak, for pathologists to evaluate themselves compared to the opinions of many of their colleagues.

• Elizabeth McMahon

  And I wanted to wrap by asking what kind of impact these new proficiency testing programs have on patient outcomes in health care?

• Dr. Emily Meserve

  Yeah, for sure. Well, I would, okay, so I think of it this way. Well, every diagnostic pathologist probably knows that you kind of have to put in the reps, so to speak. You have to look at a lot of cases. You have to look at a lot of cases with your colleagues. You have to be willing to compare, you know, your opinion with somebody else's and, you know, with a growth mindset, be open to an opportunity to learn, to improve, you know, to continue to advance your practice. So I think kind of fundamentally that's where this sits right now is it's a tool. for pathologists to use to just expose themselves to the opinions of the IHC committee, you know, consensus opinion of the IHC committee. And I think it's important for people to know that the IHC committee is composed of a representative group of pathologists in a variety of practice environments, a variety of geographic settings. So when we say consensus, we are really trying to represent broad consensus across a variety of pathologists, not just subspecialists in one organ system or pathologists at one institution, right? So I think that's important and then in terms of patient outcomes in healthcare like fundamentally predictive IHC is about identifying with accuracy the patients who are going to benefit from drug giving those patients you know giving the information to clinicians so those patients get the right drug and excluding patients from that drug. who won't benefit from it. And when you do that successfully, those patients avoid the risk of potential side effects associated with those drug regimens. So I guess I don't want to overstate it too much, but I do think that that's the fundamental crux here. We're trying to get the information that allows the right drug to get to the right patient and prevent the wrong drug from going to the patient. And I think that leads to improved patient outcomes and overall better utilization of health care resources.

• Elizabeth McMahon

  That wraps up today's Daily Edition. You can find more details on all of these stories in our show notes. Don't miss our advocacy newsletter on Tuesdays and our weekly edition newsletter on Thursdays. We'll be back tomorrow at 5 a.m. Eastern. You can subscribe to this show on Apple, Spotify, or your favorite podcast app. I'm Elizabeth McMahon. Have a great day.