Systemic approaches for multifocal bronchioloalveolar carcinoma: Is there an appropriate target? Journal Article
| Authors: | Levy, B. P.; Drilon, A.; Makarian, L.; Patel, A. A.; Grossbard, M. L. |
| Article Title: | Systemic approaches for multifocal bronchioloalveolar carcinoma: Is there an appropriate target? |
| Abstract: | Bronchioloalveolar carcinoma (BAC) is a subset of pulmonary adenocarcinoma characterized by distinct and unique pathological, molecular, radiographic, and clinical features. While the incidence of pure BAC is rare, comprising only 1% to 4% of nonsmall-cell lung cancer (NSCLC), mixed subtypes (including BAC with focal invasion and adenocarcinoma with BAC features) represent as much as 20% of adenocarcinomasand that figure may be increasing. Despite the longstanding recognition of this entity, there is no established treatment paradigm for patients with multifocal BAC, resulting in competing approaches and treatment controversies. Current options for multifocal BAC include both surgery and systemic therapies. Unfortunately, prospective data on systemic approaches are limited by study design and small patient numbers; there are only seven phase II studies involving four therapies. This article evaluates key characteristics of BAC, including the current understanding of histopathology and tumor biology. In addition, it comprehensively reviews the systemic phase II studies in an attempt to clarify the therapeutic challenges in this disease. It also includes the first proposed treatment paradigm that integrates both EGFR mutational status and the sub-histologies, mucinous and nonmucinous BAC. |
| Keywords: | immunohistochemistry; cancer chemotherapy; treatment response; cancer surgery; overall survival; clinical trial; fatigue; histopathology; neutropenia; review; erlotinib; diarrhea; side effect; systemic therapy; treatment duration; gemcitabine; paclitaxel; cancer patient; cancer radiotherapy; positron emission tomography; cancer incidence; polymerase chain reaction; progression free survival; computer assisted tomography; infection; multiple cycle treatment; nausea; continuous infusion; retrospective study; cetuximab; aminotransferase blood level; asthenia; febrile neutropenia; loading drug dose; rash; death; cyclin dependent kinase inhibitor 1b; phosphatidylinositol 3,4,5 trisphosphate 3 phosphatase; gefitinib; lung alveolus cell carcinoma; molecular biology; k ras protein; pemetrexed; fluorodeoxyglucose; mucinous carcinoma; hypertransaminasemia; pharyngitis; radiological parameters; transminitis |
| Journal Title: | Oncology (Norwalk) |
| Volume: | 24 |
| Issue: | 10 |
| ISSN: | 0890-9091 |
| Publisher: | C M P Medica LLC * The Oncology Group |
| Date Published: | 2010-09-22 |
| Start Page: | 888 |
| End Page: | 898, 900 |
| Language: | English |
| PROVIDER: | scopus |
| PUBMED: | 21138169 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 20 April 2011" - "CODEN: OCLGE" - "Source: Scopus" |
