Diagnosis and treatment of bronchioloalveolar carcinoma.
OBJECTIVE
Bronchioloalveolar carcinoma accounts for 5% of lung cancers, although histologically mixed bronchioloalveolar carcinoma and adenocarcinoma account for up to 20%. Bronchioloalveolar carcinoma histology is present in a majority of tumors found on lung-cancer screening by computed tomography. We review issues surrounding the diagnosis and treatment of bronchioloalveolar carcinoma, which often differs from other types of lung cancer.


RESULTS
A spectrum of disease from histologically pure bronchioloalveolar carcinoma to adenocarcinoma exists. The approach to treatment of diseases within this spectrum is still evolving. Evidence on the role of sub-lobar resection, resection of multifocal disease, and pulmonary transplantation is reviewed. We also discuss epidermal growth factor receptor tyrosine kinase inhibitors, and their role in patients with bronchioloalveolar carcinoma.


CONCLUSIONS
An understanding of recent developments in the diagnosis and treatment of patients with bronchioloalveolar carcinoma histology is important as early detection of lung cancer becomes more common. Ongoing clinical trials will provide important information on the role of limited resection. The use of epidermal growth factor receptor tyrosine kinase inhibitors should currently be limited to patients with advanced or recurrent disease who have failed cytotoxic chemotherapy. New targeted therapies are emerging for patients with bronchioloalveolar carcinoma histology.
Raz
Dan J
DJ
University of California, San Francisco, Department of Surgery, San Francisco, California 94143-0470, USA. dan.raz@ucsf.edu
Kim
Jae Y
JY
Jablons
David M
DM
D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000175:diagnosis* / Q000628:therapy*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002277:Carcinoma / Q000175:diagnosis* / Q000628:therapy*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D006801:Humans; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D066246:ErbB Receptors