Pathology Evidence Evolution

5 evidence evolution narratives tracing how landmark trials and guideline updates reshaped pathology practice.

HER2 Classification Evolution

Redefining a binary test

Binary → FISH reflex → equivocal → HER2-low → T-DXd changes everything

From single gene to comprehensive panels

Single gene → hotspot panels → NGS → MSI/TMB → liquid biopsy

Four assays, one problem

No biomarker → 4 assays/4 drugs → Blueprint harmonization → CPS vs TPS → variability

Blood draws replace biopsies

Research curiosity → ctDNA for EGFR → MRD monitoring → screening (Galleri)

The computational microscope

Microscope only → WSI → computational pathology → AI diagnostic aids → FDA clearances