The Fall and Rise of Immunohistochemistry
Emina TorlakovicMD, FRCPC
Dr. Emina Emilia Torlakovic obtained her M.D. at the University of Zagreb Medical School and her Ph.D. at the University of Oslo Medical School. She is certified by The American Board of Pathology in Anatomic and Clinical Pathology with subspecialty boards in Hematopathology.
She is a professor at the Department of Pathology and Laboratory Medicine, University of Saskatchewan and a Division Head of Hematopathology, Saskatchewan Health Authority. She was a founding member of the NordiQC, has co-founded CIQC, and founded Canadian Biomarker Quality Assurance (CBQA) as well as CBQAReadout.ca (inter)national academic quality assurance programs, which she is currently directing. Dr. Torlakovic is the Chair of the National Standards Committee for High Complexity Testing of the Canadian Association of Pathologists, which published several Canadian guidelines for standardization of IHC testing. Dr. Torlakovic chaired the International Council for Standardization in Hematology (ICSH) Working Party, which developed international guidelines for bone marrow IHC and is currently chairing ICSH Working Party for standardization of CD34 testing in the bone marrow biopsy. She was/is a member of the ASCO/CAP expert panel that published guidelines for hormone receptor testing in breast cancer in 2010 and an updated guideline in 2020. She is the President of the International Society for Immunohistochemistry and Molecular Morphology (ISIMM) and a Board Member of the International Quality Network for Pathology (IQN Path). Dr. Torlakovic has published over 100 peer reviewed manuscripts, authored a book on Bone Marrow Immunohistochemistry, and has lectured widely nationally and internationally on immunohistochemistry, quality assurance, and hematopathology.
The lack of reference standards, quantitative calibrated controls, extensive use of laboratory developed assays, imprecision of immunohistochemistry (IHC) protocols, and inherently imprecise readouts of the stained slides, to name a few, led to widely recognized inter- as well as intra-laboratory variation of IHC results. However, the development of precision medicine led to high expectation of accuracy for all assays used as predictive assays in conjunction with targeted therapy and/or immunotherapy including IHC. This demand led to deconstruction and reconstruction of IHC as methodology and the employment of new concepts applied to quality assurance of IHC. The new concepts and recommendations from the four papers, so-called “Evolution Series”, Evolution of Quality Assurance for Clinical Immunohistochemistry in the Era of Precision Medicine: Part 1 to Part 4″, are summarized in this presentation.
At the end of this session, participants will be able to:
Distinguish between the fit-for-purpose immunohistochemistry assay and immunohistochemistry assay with best signal-to-noise ratio
Identify immunohistochemistry test performance characteristics and tissue tools relevant to daily practice as well as IHC test development and validation.
Target Audience: Pathologists, Residents, Medical Students
CanMEDS Roles: Medical Expert (the integrating role), Communicator, Collaborator, Leader
Declaration of Conflict of Interest
Direct financial payments including receipt of honoraria Astellas Pharma; relationship: Consultancy
Membership on advisory boards: Merck, Pfizer, BMS, Abbvie, Roche