Three of the world's top lung associations have published a new international multidisciplinary classification of lung adenocarcinoma, the first revision to the classification in six years.
The new classification is published in the February edition of the Journal of Thoracic Oncology, the official publication of the International Association for the Study of Lung Cancer (IASLC).
"With the many rapid advances in lung adenocarcinoma affecting clinical, radiologic, pathologic, molecular and surgical aspects of this cancer, it was necessary to develop a new classification using an international multidisciplinary consensus committee," said Dr. William Travis, attending thoracic pathologist at Memorial Sloan Kettering Cancer Center in New York City. "Since lung cancer is the most common cause of cancer mortality worldwide and adenocarcinoma is the most common histologic subtype in most countries, this classification addresses a major public health problem."
The IASLC was the primary sponsor of the project, which was performed with support and scientific oversight from the American Thoracic Society and the European Respiratory Society. An international core panel of experts representing the three organizations was formed to conduct the review; it included oncologists/pulmonologists, pathologists, radiologists, molecular biologists and thoracic surgeons.
Unlike previous classifications published by the World Health Organization (WHO) in 1967, 1981 and 1999, which were written primarily by pathologists for pathologists, the new classification takes into account advances across diverse specialties in the understanding of lung adenocarcinoma. Although the 2004 revision introduced relevant genetics and clinical information, the new classification is the first to be based on an integrated multidisciplinary platform.
"All previous WHO classifications have been developed by pathologists with little input from other specialties," 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;
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.
About the Journal of Thoracic Oncology:
The Journal of Thoracic Oncology (JTO) is the official monthly journal of the International Association for the Study of Lung Cancer (IASLC). It is a prized resource for medical specialists and scientists who focus on the detection, prevention, diagnosis and treatment of lung cancer. It emphasizes a multidisciplinary approach, including original research (clinical trials and translational or basic research), reviews and opinion pieces.
To find out more about the JTO please visit journals.lww.com. To learn more about the IASLC please visit iaslc.org.
Renée McGaw | EurekAlert!
On track to heal leukaemia
18.01.2017 | Universitätsspital Bern
Penn vet research identifies new target for taming Ebola
12.01.2017 | University of Pennsylvania
Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...
Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.
While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...
Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales
Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...
Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.
As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...
At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).
Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...
10.01.2017 | Event News
09.01.2017 | Event News
05.01.2017 | Event News
18.01.2017 | Power and Electrical Engineering
18.01.2017 | Materials Sciences
18.01.2017 | Life Sciences