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Lung societies unveil new international classification of lung adenocarcinoma
Date:1/31/2011

alties," Travis said.

One of the key new recommendations is that epidermal growth factor receptor (EGFR) mutation testing be performed for patients with advanced lung adenocarcinoma, due to the predictive benefit for response rate and progression-free survival for mutation-positive patients who are treated with tyrosine kinase inhibitors.

A completely new aspect of this classification, which was not addressed in previous WHO classifications, is a section that addresses diagnosis and classification of non-small cell carcinoma in small biopsies and cytology, Travis said. "This is important because 70% of lung cancers present in advanced stages," Travis said. "This section not only provides new criteria for diagnosis of adenocarcinoma versus squamous cell carcinoma that includes use of special stains in difficult cases, but it also stresses the importance of preserving tissue for molecular studies."

There are three major clinical reasons why it is important for pathologists to distinguish adenocarcinoma from squamous cell carcinoma, particularly in advanced lung cancer:

  • adenocarcinoma or unspecified NSCLC should be tested for EGFR mutations, which would indicate responsiveness to EGFR tyrosine kinase inhibitors;
  • patients with adenocarcinoma or unspecified NSCLC respond better to pemetrexed therapy than those with squamous cell carcinoma;
  • potential life-threatening hemorrhage may occur in patients with squamous cell carcinoma who receive bevacizumab.

The new classification recommends discontinuing use of the term bronchioloalveolar carcinoma (BAC) as tumors previously classified under this term fall into five different places in the new classification.

New concepts of "adenocarcinoma in situ" and "minimally invasive adenocarcinoma" were introduced to define patients who should have 100% or near 100% disease-free survival, respectively.


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Contact: Rene McGaw
renee.mcgaw@ucdenver.edu
303-724-5796
International Association for the Study of Lung Cancer
Source:Eurekalert

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