Paradigm shifts in lung cancer as defined in the new IASLC/ATS/ERS lung adenocarcinoma classification
William D. Travis,Elisabeth Brambilla,P. Van Schil,G.V. Scagliotti,Rudolf M. Huber,J-P Sculier,Johan Vansteenkiste,Andrew G. Nicholson +7 more
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TLDR
A series of major paradigm shifts are outlined in this classification that will result in major changes in the approach to diagnosis of lung cancer compared to those outlined in previous World Health Organization (WHO) classifications.Abstract:
The new international multidisciplinary lung adenocarcinoma classification is sponsored by the European Respiratory Society (ERS), as well as the International Association for the Study of Lung Cancer (IASLC) and the American Thoracic Society (ATS) [1]. This classification is now published in the Journal of Thoracic Oncology , the official journal of the IASLC. Under the scientific oversight of the ATS and ERS, the classification project involved a systematic review to provide an evidence-based foundation with specific recommendations.
For decades, the field of lung cancer has been relatively static with few major advances. However, in the past 5–6 yrs this has changed to a rapidly evolving field. At the heart of this change is the impact of the molecular discovery that the activating mutations in the epidermal growth factor receptor ( EGFR ) are a marker for response and improved progression-free survival with tyrosine kinase inhibitor (TKI) therapy compared to conventional chemotherapy in advanced lung adenocarcinoma patients [2–5].
In this editorial, we summarise a series of major paradigm shifts that are outlined in this classification that will result in major changes in the approach to diagnosis of lung cancer compared to those outlined in previous World Health Organization (WHO) classifications. While this classification is primarily focused on lung adenocarcinoma, many of the recommendations will impact on how all histologic types of lung cancer are diagnosed in the future. This classification is divided into two major components: classification based on resection specimens (table 1) and on small biopsies and cytology (table 2).
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Table 1– 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification of lung adenocarcinoma in resection specimens
View this table:
Table 2– Proposed International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification for small biopsies/cytology
Historically, tumour classification has been primarily been performed by the WHO with panels primarily consisting of pathologists [6–9]. Due to the many major advances that have occurred at each level (pathology, molecular biology, radiology, respiratory medicine, oncology and surgery) this current …read more
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References
More filters
Journal ArticleDOI
Gefitinib or Carboplatin–Paclitaxel in Pulmonary Adenocarcinoma
Tony Mok,Yi-Long Wu,Sumitra Thongprasert,Chih-Hsin Yang,Da Tong Chu,Nagahiro Saijo,Patrapim Sunpaweravong,Baohui Han,Benjamin Margono,Benjamin Margono,Yukito Ichinose,Yutaka Nishiwaki,Yuichiro Ohe,Jin Ji Yang,Busyamas Chewaskulyong,Haiyi Jiang,Emma Duffield,Claire Watkins,Alison Armour,Masahiro Fukuoka +19 more
TL;DR: Gefit inib is superior to carboplatin-paclitaxel as an initial treatment for pulmonary adenocarcinoma among nonsmokers or former light smokers in East Asia and the presence in the tumor of a mutation of the EGFR gene is a strong predictor of a better outcome with gefitinib.
Journal ArticleDOI
Gefitinib or Chemotherapy for Non–Small-Cell Lung Cancer with Mutated EGFR
Makoto Maemondo,Akira Inoue,Kunihiko Kobayashi,Shunichi Sugawara,Satoshi Oizumi,Hiroshi Isobe,Akihiko Gemma,Masao Harada,Hirohisa Yoshizawa,Ichiro Kinoshita,Yuka Fujita,Shoji Okinaga,Haruto Hirano,Kozo Yoshimori,Toshiyuki Harada,Takashi Ogura,Masahiro Ando,Hitoshi Miyazawa,Tomoaki Tanaka,Yasuo Saijo,Koichi Hagiwara,Satoshi Morita,Toshihiro Nukiwa +22 more
TL;DR: First-line gefitinib for patients with advanced non-small-cell lung cancer who were selected on the basis of EGFR mutations improved progression-free survival, with acceptable toxicity, as compared with standard chemotherapy.
Journal ArticleDOI
Anaplastic Lymphoma Kinase Inhibition in Non–Small-Cell Lung Cancer
Eunice L. Kwak,Yung-Jue Bang,D. Ross Camidge,Alice T. Shaw,Benjamin Solomon,Robert G. Maki,Sai-Hong Ignatius Ou,Bruce J. Dezube,Pasi A. Jänne,Daniel B. Costa,Marileila Varella-Garcia,Woo-Ho Kim,Thomas J. Lynch,Panos Fidias,Hannah Stubbs,Jeffrey A. Engelman,Lecia V. Sequist,Weiwei Tan,Leena Gandhi,Mari Mino-Kenudson,Greg C. Wei,S. Martin Shreeve,Mark J. Ratain,Jeffrey Settleman,James G. Christensen,Daniel A. Haber,Keith D. Wilner,Ravi Salgia,Geoffrey I. Shapiro,Jeffrey W. Clark,A. John Iafrate +30 more
TL;DR: The inhibition of ALK in lung tumors with the ALK rearrangement resulted in tumor shrinkage or stable disease in most patients, and the drug resulted in grade 1 or 2 gastrointestinal side effects.
Journal ArticleDOI
International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society International Multidisciplinary Classification of Lung Adenocarcinoma
William D. Travis,Elisabeth Brambilla,Masayuki Noguchi,Andrew G. Nicholson,Kim R. Geisinger,Yasushi Yatabe,David G. Beer,Charles A. Powell,Gregory J. Riely,Paul Van Schil,Kavita Garg,John H. M. Austin,Hisao Asamura,Valerie W. Rusch,Fred R. Hirsch,Giorgio V. Scagliotti,Tetsuya Mitsudomi,Rudolf M. Huber,Yuichi Ishikawa,James R. Jett,Montserrat Sanchez-Cespedes,Jean-Paul Sculier,Takashi Takahashi,Masahiro Tsuboi,Johan Vansteenkiste,Ignacio I. Wistuba,Pan-Chyr Yang,Denise R. Aberle,Christian Brambilla,Douglas B. Flieder,Wilbur A. Franklin,Adi F. Gazdar,Michael K. Gould,Philip S. Hasleton,Douglas W. Henderson,Bruce E. Johnson,David A Johnson,Keith M. Kerr,Keiko Kuriyama,Jin Soo Lee,Vincent A. Miller,Iver Petersen,Victor L. Roggli,Rafael Rosell,Nagahiro Saijo,Erik Thunnissen,M. Tsao,David Yankelewitz +47 more
TL;DR: This new adenocarcinoma classification is needed to provide uniform terminology and diagnostic criteria, especially for bronchioloalveolar carcinoma (BAC), the overall approach to small nonresection cancer specimens, and for multidisciplinary strategic management of tissue for molecular and immunohistochemical studies.
Journal ArticleDOI
Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomised phase 3 trial
Tetsuya Mitsudomi,Satoshi Morita,Yasushi Yatabe,Shunichi Negoro,Isamu Okamoto,Junji Tsurutani,Takashi Seto,Miyako Satouchi,Hirohito Tada,Tomonori Hirashima,Kazuhiro Asami,Nobuyuki Katakami,Minoru Takada,Hiroshige Yoshioka,Kazuhiko Shibata,Shinzoh Kudoh,Eiji Shimizu,Hiroshi Saito,Shinichi Toyooka,Kazuhiko Nakagawa,Masahiro Fukuoka +20 more
TL;DR: In this article, an open label, phase 3 study (WJTOG3405) with recruitment between March 31, 2006, and June 22, 2009, at 36 centers in Japan was conducted.
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