Systemic approaches for multifocal bronchioloalveolar carcinoma

is there an appropriate target?

Benjamin P. Levy, Alexander Drilon, Liana Makarian, Amit A. Patel, Michael L. Grossbard

Research output: Contribution to journalReview article

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 non-small-cell lung cancer (NSCLC), mixed subtypes (including BAC with focal invasion and adenocarcinoma with BAC features) represent as much as 20% of adenocarcinomas--and 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.

Original languageEnglish (US)
JournalOncology (Williston Park, N.Y.)
Volume24
Issue number10
StatePublished - Sep 1 2010
Externally publishedYes

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Bronchiolo-Alveolar Adenocarcinoma
Adenocarcinoma
Therapeutics
Non-Small Cell Lung Carcinoma
Histology
Incidence

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Systemic approaches for multifocal bronchioloalveolar carcinoma : is there an appropriate target? / Levy, Benjamin P.; Drilon, Alexander; Makarian, Liana; Patel, Amit A.; Grossbard, Michael L.

In: Oncology (Williston Park, N.Y.), Vol. 24, No. 10, 01.09.2010.

Research output: Contribution to journalReview article

Levy, Benjamin P. ; Drilon, Alexander ; Makarian, Liana ; Patel, Amit A. ; Grossbard, Michael L. / Systemic approaches for multifocal bronchioloalveolar carcinoma : is there an appropriate target?. In: Oncology (Williston Park, N.Y.). 2010 ; Vol. 24, No. 10.
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AU - Grossbard, Michael L.

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