{"entity":{"id":"genomic-testing-biliary-uk","kind":"term","name":"HER2 and genomic testing for biliary cancer on the NHS","aka":[],"tldr":"Asking for HER2 testing and a tumour gene panel at diagnosis of advanced gallbladder cancer is reasonable, because about one in ten tumours is HER2-positive on staining (more carry a HER2 gene change) and a HER2 antibody is now funded on the NHS; the test is arranged by your hospital team on a sample already taken.","summary":"Gallbladder cancer carries HER2 changes more often than other biliary cancers: about one in ten resected tumours is HER2-positive on staining by the trial rule (9.4 percent of 53, Angerilli 2026) and about one in seven carries an ERBB2 gene alteration by sequencing (14 to 16 percent, Mondaca 2024; Giraldo 2022), with higher figures in Japanese series scored by the gastric rule; the molecular rows on the main gallbladder cancer page give each cohort. Zanidatamab was approved by the MHRA in February 2026 for HER2-positive biliary tract cancer after chemotherapy and NICE recommended it in May 2026 (TA1153). Mismatch repair deficiency, BRAF V600E and NTRK fusions open tumour-agnostic options, so the NCCN guideline asks for molecular profiling of all advanced biliary cancers. AMMF's molecular profiling booklet explains that \"a small sample of tumour or blood is tested to see if there are gene mutations or rearrangements which 'drive' the cancer\" and that \"if there are, then there may be a targeted treatment option\".\n\nOn the NHS, testing is requested by the specialist: the NHS page says \"you need to be referred for genetic testing by a doctor. Talk to your hospital specialist about whether testing is right for you\", and for cancer \"the test will be done on a sample of the tumour that has already been removed as part of your treatment\", through the NHS Genomic Medicine Service. Questions worth asking: whether HER2 has been tested by immunohistochemistry and in situ hybridisation, whether a gene panel has been sent and how long it takes, whether there is enough tissue or a fresh biopsy is needed, and whether the results would change the treatment you are offered. This is orientation from public patient pages, not advice for your case: your own team's instructions and 24-hour number come first.","asOf":"2026-09-24","links":[{"label":"NHS: genetic and genomic testing","url":"https://www.nhs.uk/tests-and-treatments/genetic-and-genomic-testing/"},{"label":"AMMF: molecular profiling booklet","url":"https://ammf.org.uk/molecular-profiling-booklet-and-video/"},{"label":"MHRA approves zanidatamab (Ziihera) for biliary tract cancer (GOV.UK, 2026)","url":"https://www.gov.uk/government/news/mhra-approves-zanidatamab-ziihera-for-the-treatment-of-biliary-tract-cancer"},{"label":"ESMO: biliary tract cancer, a guide for patients","url":"https://www.esmo.org/for-patients/patient-guides/biliary-tract-cancer-a-guide-for-patients"}],"tags":[],"related":[],"cancers":["gallbladder"],"sections":[],"technologies":["cgp"],"targets":["her2"],"drugs":["her2-testing-assays","zanidatamab"],"companies":[],"institutions":[],"pathways":[],"terms":["genomic-profiling","tumour-agnostic","msi"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Genomics & genetics"},"route":"/terms/genomic-testing-biliary-uk/","neighbours":{"cancer":[{"id":"gallbladder","kind":"cancer","name":"Gallbladder cancer","route":"/cancers/gallbladder/"}],"technology":[{"id":"cgp","kind":"technology","name":"Comprehensive genomic profiling","route":"/technologies/cgp/"}],"target":[{"id":"her2","kind":"target","name":"HER2","route":"/targets/her2/"}],"drug":[{"id":"her2-testing-assays","kind":"drug","name":"HER2 IHC and ISH companion assays (HercepTest, PATHWAY 4B5, HER2 Dual ISH)","route":"/drugs/her2-testing-assays/"},{"id":"zanidatamab","kind":"drug","name":"Zanidatamab","route":"/drugs/zanidatamab/"}],"term":[{"id":"genomic-profiling","kind":"term","name":"Genomic profiling","route":"/terms/genomic-profiling/"},{"id":"msi","kind":"term","name":"Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR)","route":"/terms/msi/"},{"id":"tumour-agnostic","kind":"term","name":"Tumour-agnostic (tissue-agnostic) approval","route":"/terms/tumour-agnostic/"}]}}