June 2022

June 2022—The latest advance in breast cancer treatment is a big one—the promising antibody drug conjugate fam-trastuzumab deruxtecan-nxki, or T-DXd (Enhertu). The drug was granted break­through therapy designation this spring for patients with HER2-low metastatic breast cancer, and the drug and trial on which the decision was based were the focus of the plenary session at the ASCO annual meeting in early June. “This drug in particular is a variant of a drug we are all very familiar with—Herceptin, or trastuzumab,” says David Rimm, MD, PhD, the Anthony N. Brady professor of pathology, professor of medicine (oncology), director of the translational pathology and Yale pathology tissue services, and director of the physician scientist training program in pathology, Department of Pathology, Yale University School of Medicine. Also familiar: the IHC test to determine eligibility for the drug, a companion diagnostic developed decades ago. But that’s where easy familiarity ends.

June 2022—By revealing the value of a diagnostic algorithm using quantitative RNA as the second test to confirm reactive HIV screening results, Daniel Gromer, MD, and colleagues say their simulation modeling suggests clinical improvement over the standard-of-care algorithm, and at lower cost if HIV specimen positivity is high.

June 2022—Jobs in pathology are plentiful and positions are hard to fill, which has put the pipeline in the limelight. CAP TODAY publisher Bob McGonnagle led a virtual discussion with two pathologists and a pathology resident.

June 2022—For many blood suppliers, there is more enthusiasm for low titer O whole blood than there is an ability to make it, especially with the pandemic having made it harder than ever to collect.

June 2022—What to look for in serous fluid cytology is what Eva M. Wojcik, MD, of Loyola University in Chicago, and Xiaoyin “Sara” Jiang, MD, of Duke Health, set forth in their CAP21 session last year.

June 2022—The effects of acute cannabis on driving performance and how impaired drivers can be detected will be reported at the AACC annual meeting July 24–28. Sessions on serum COVID-19 antibodies and lab workforce solutions are two more of the many that await attendees in Chicago.

June 2022—What stood out among all that was seen and heard at the Executive War College? Compass Group members who were there answer CAP TODAY publisher Bob McGonnagle’s question in their early May virtual get-together, shortly after the War College took place. Here’s what they and other lab leaders said about retail lab testing, digital pathology and artificial intelligence, and their plans for the future.

June 2022—How race shows up in the medical school curriculum and what to do about it was the focus of a grand rounds by Andrea T. Deyrup, MD, PhD, and Joseph L. Graves Jr., PhD, presented virtually this spring to the University of Minnesota Department of Laboratory Medicine and Pathology, on behalf of the department’s diversity, equity, and inclusion committee.

June 2022—You’re probably familiar with the expression “jack of all trades, master of none.” While that sounds disparaging, it’s actually taken out of context. The original quote in its entirety is, “A jack of all trades is a master of none, but oftentimes better than a master of one.” It was intended as a compliment for someone who had good, broad knowledge. The widespread misinterpretation of that quote supports a common idea that no individual can be really good at a lot of different things. But pathologists challenge that concept every day. While many of us subspecialize, we are able to fall back on our broad training when circumstances require it. Such may be the case when encountering pathologic findings that indicate a disorder not commonly found in our area of expertise, or findings that indicate a systemic illness. Many of us find that we have to be experts on different things on different days and in different parts of our career.

June 2022—Medical student visiting, or “away,” rotations usually occur in medical students’ fourth year and often align with participants’ specialty of interest at an institution for which they have an interest in the residency program.

June 2022—Appendiceal orifice mucosae often appear inflamed endoscopically, even when other colonic segments appear normal. Histological findings in biopsy samples taken from endoscopically abnormal mucosae may simulate a variety of inflammatory colitides.

June 2022—Sickle cell disease is caused by a point mutation in the gene encoding β-globin and is characterized by chronic hemolytic anemia, painful vaso-occlusive events, and increased risk of early death. The disease can be managed using supportive therapy, but this does not halt its progression.

June 2022—Laboratories seeking a means to query their repository of archival anatomic pathology reports would do well to follow the advice of former tennis star Arthur Ashe: “Start where you are, use what you have, do what you can.”

June 2022 Q. Can bronchoalveolar lavage specimens from multiple lobes be pooled for culture? Can multiple biopsies from the same joint be pooled for culture? Read answer. Q. We verify our reference intervals with each new reagent lot for coagulation tests (PT, APTT, fibrinogen, and TT). What difference in values between lots necessitates establishing a new reference interval? A CAP TODAY Q&A from January 2015 mentions limits within 1.5 seconds of each other between new and old reagent lots for human recombinant PT. What about limits for APTT and fibrinogen? Read answer.

June 2022—The CAP issued a statement on April 5 in support of the ADVANCE study, which hopes to end discriminatory practices based on sexual identity and/or sexual orientation in donor risk assessments and deferral periods for blood donation. Originally, the FDA instituted such discriminatory criteria on the assumption that potential donors who are gay and bisexual men who have sex with men are at an increased risk of transmission of communicable diseases, such as human immunodeficiency virus. If the results of the ADVANCE study prove this antiquated idea false, the FDA will hopefully amend the official guidance on donor eligibility for blood donation.

June 2022—Daiichi Sankyo and AstraZeneca’s Enhertu (fam-trastuzumab deruxtecan-nxki) in April was granted breakthrough therapy designation for treating patients with unresectable or metastatic HER2-low (IHC 1+ or IHC 2+/ISH-negative) breast cancer who have received a prior systemic therapy in the metastatic setting or developed recurrence during or within six months of completing adjuvant chemotherapy.