[Therapeutic management of extensive bronchiolo-alveolar adenocarcinoma: chemotherapy or inhibitors of epidermal growth factor receptor tyrosine kinase?].
Although the 1999 WHO classification, revised in 2004 excludes stage IIIB-IV tumors from the definition of bronchioloalveolar carcinoma (BAC) because they are unresectable, the first international workshop (November 2004, New York) devoted to this tumor emphasized the continuum between the BAC as defined by the WHO and adenocarcinomas with a BAC-like component which presents similar epidemiological, biological, clinical, radiological, prognostic and therapeutic features. These observations led to the suggestion to no include stage IIIB-IV ADC-BAC in studies designed for other non-small-cell lung cancers. The purpose of this review was to analyze the results of prospective studies currently available concerning the treatment of stage IIIB-IV ADC-BAC. No evidence is available with combination regimens using platine. Monotherapy with paclitaxel appears to have efficacy similar to inhibitors of epidermal growth factor receptor tyrosine kinase (gefitinib and erlotinib) (TKI-EGFR). The tolerance profile is in favor of using TKI-EGFR. It would appear that tumors responding to paclitaxel and to TKI-EGFR correspond to different diseases. These observations point out the importance of further studies examining the proper strategy and to search for new compounds for the treatment of extensive ADC-BAC.
Service de Pneumologie et Réanimation Respiratoire, Hôpital Tenon, AP-HP, 4, rue de la Chine, 75970 Paris Cedex 20. jacques.cadranel@tnn.aphp.fr
J
J
Cadranel
M
M
Wislez
V
V
Gounant
A
A
Lavolé
M
M
Antoine
B
B
Milleron
D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000188:drug therapy*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D000069347:Erlotinib Hydrochloride; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D017239:Paclitaxel / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011799:Quinazolines / Q000627:therapeutic use
D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors; D017239:Paclitaxel; D000077156:Gefitinib