Southwestern Oncology Group Phase II Trial (S0526) of Pemetrexed in Bronchioloalveolar Carcinoma Subtypes of Advanced Adenocarcinoma

Lau, Derick H; Moon, James; Davies, Angela M.; Sanborn, Rachel E.; Hirsch, Fred R.; Franklin, Wilbur A.; Ruzich, Janet; Redman, Mary W.; Gandara, David R.

doi:10.1016/j.cllc.2012.12.004

Cited by 8 publications

(11 citation statements)

References 13 publications

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“…Our DCR and PFS results were similar to those previously reported in an advanced BAC population [4,5,[7][8][9][10][11]. DCR did not differ between therapeutic arms or pathological subtypes, although there was a strong interaction between treatment effect (arm E versus CP) on PFS and mucinous and NM subtypes (p=0.009) (figure 3), as previous studies have suggested [10].…”

Section: Discussionsupporting

confidence: 79%

“…Our study population was similar to that of previous trials assessing advanced BAC, especially in terms of the relative proportion of NM (51%) and mucinous (42%) tumours [5,7,8,9,10,11]. In line with previous reports, EGFR and KRAS mutations were detected in 5.6% (6-22%) [9,10,11] and 27% (10-30%) [2,3] of cases, respectively.…”

Section: Discussionsupporting

confidence: 75%

“…Only two nonrandomised phase II trials had previously investigated the efficacy of paclitaxel monotherapy, administered every 3 weeks [4,5], but the low response rates and unacceptable toxicity reported by the Southwest Oncology Group (SWOG) 9714 trial defined this approach as ill adapted [5]. Pemetrexed monotherapy has recently achieved promising results in the Intergroupe Francophone de Cancérologie Thoracique (French Cooperative Thoracic Intergroup (IFCT)) 0401 trial [6] and in one prematurely closed phase II trial [7]. Three phase II trials have evaluated the use of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) as first-or second-line treatment for advanced ADC-BAC [8][9][10], demonstrating encouraging efficacy and a favourable toxicity profile.…”

Section: Introductionmentioning

confidence: 99%

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Erlotinibversuscarboplatin and paclitaxel in advanced lepidic adenocarcinoma: IFCT-0504

Cadranel¹,

Gervais²,

Merle³

et al. 2015

Eur Respir J

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The IFCT-0504 phase II trial evaluated the efficacy of erlotinib versus carboplatin-paclitaxel (CP) as first-line treatment in 130 cases of advanced lepidic-predominant adenocarcinoma (ADC).The primary objective of the study was treatment efficacy, evaluated based on an end-point of disease control at 16 weeks.The primary objective was met, with a disease control in 35 (53%) out of 66 patients treated with CP and in 25 (39.1%) out of 64 patients treated with erlotinib. Median progression-free survival (PFS) for the total population was 3.6 months. The disease control rate did not differ between either the therapeutic arms or pathological subtypes, whereas there was a strong interaction between treatment arms and tumour pathological subtypes for PFS ( p=0.009). Mucinous tumour patients treated with erlotinib exhibited an increased progression risk (hazard ratio 3.4, 95% CI 1.7-6.5; p⩽0.001). The PFS for nonmucinous tumour patients was similar in both arms. Median overall survival was 20.1 months and did not differ between therapeutic arms. These findings were not further elucidated by molecular analyses and the toxicity profiles were as expected.Our study demonstrated the dominant role of CP alongside erlotinib in the management of advanced lepidic ADC. Based on these findings, erlotinib should not be administered in first-line therapy to patients with lepidic ADC in the absence of an epidermal growth factor receptor mutation. @ERSpublications Interaction between pathological subtypes and treatment (erlotinib/chemotherapy) in advanced lepidic adenocarcinoma

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

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Erlotinibversuscarboplatin and paclitaxel in advanced lepidic adenocarcinoma: IFCT-0504

Cadranel¹,

Gervais²,

Merle³

et al. 2015

Eur Respir J

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“…Response rates to chemotherapy have been reported between 21% to 32% (18), and were either lower than or equal to the rates in patients with all types of adenocarcinoma. Pemetrexed has been reported to be active and well tolerated in patients with adenocarcinoma BAC subtypes (19). In this case, the patient did not get response to chemotherapies (including pemetrexed).…”

Section: B a C D E Fmentioning

confidence: 78%

Recurrent “pneumonia” in left lower lobe lasting for 8 years: a case report

Yuan¹,

Yao²,

Li³

et al. 2016

Transl. Lung Cancer Res.

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Bronchioloalveolar carcinoma (BAC) is a unique lung neoplasm with variable forms, such as single nodular, multifocal and lobar pneumonic types. The pneumonic type BAC is often difficult to differentiate from pneumonia. Here we present a case of 63-year-old Chinese male, who had recurrent cough, white sputum with pneumonic lesions in left lower lobe. He suffered from lung biopsies for three times, and finally diagnosed as high differentiated adenocarcinoma 8 years later. He was treated with four cycles of pemetrexed and cisplatin, and four cycles of docetaxel and nedaplatin. However, he did not achieve disease stabilization and is still under follow up. This case suggests that, pneumonic type adenocarcinoma may radiographically and clinically resemble infectious pneumonia. Lack of fever and leukocytosis, no response to antibiotics, air bronchogram, and accompanied nodules or patches in computed tomography (CT) scans should raise suspicion about the diagnosis of pneumonia. Lung biopsy might be the only means of ruling in a diagnosis of BAC.

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“…Several chemotherapy trials have shown median survival of about 1 year (11,12). Targeted drug trials have reported only minimal improvement so far (13)(14)(15)(16)(17)(18). Lung transplantation for BAC was not considered as a therapeutic option in the 2007 report on evidence-based clinical practice guidelines published by the American College of Chest Physicians (19).…”

Section: Primary Lung Cancermentioning

confidence: 99%

Lung cancer: a rare indication for, but frequent complication after lung transplantation

Raemdonck¹,

Vos²,

Yserbyt³

et al. 2016

J. Thorac. Dis.

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Lung transplantation is an effective and safe therapy for carefully selected patients suffering from a variety of end-stage pulmonary diseases. Lung cancer negatively affects prognosis, particularly in patients who are no longer candidates for complete resection. Lung transplantation can be considered for carefully selected and well staged lung cancer patients with proven, lung-limited, multifocal, (minimally invasive) adenocarcinoma in situ (AIS) (previously called bronchioloalveolar cell carcinoma) causing respiratory failure. Despite a substantial risk of tumour recurrence (33-75%), lung transplantation may offer a survival benefit (50% at 5 years) with best palliation of their disease. Reports on lung transplantation for other low-grade malignancies are rare. Lung transplant candidates at higher risk for developing lung cancer [mainly previous smokers with chronic obstructive lung disease (COPD) and idiopathic pulmonary fibrosis (IPF) or older patients] should be thoroughly and repeatedly screened for lung cancer prior to listing, and preferably also during waiting list time if longer than 1 year, including the use of PET-CT scan and EBUS-assisted bronchoscopy in case of undefined, but suspicious pulmonary abnormalities. Double-lung transplantation should now replace single-lung transplantation in these high-risk patients because of a 6-9% prevalence of lung cancer developing in the remaining native lung. Patients with unexpected, early stage bronchial carcinoma in the explanted lung may have favourable survival without recurrence. Early PET-CT (at 3-6 months) following lung transplantation is advisable to detect early, subclinical disease progression. Donor lungs from (former) smokers should be well examined at retrieval. Suspicious nodules should be biopsied to avoid grafting cancer in the recipient. Close follow-up with regular visits and screening test in all recipients is needed because of the increased risk of developing a primary or secondary cancer in the allograft from either donor or recipient origin.

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Southwestern Oncology Group Phase II Trial (S0526) of Pemetrexed in Bronchioloalveolar Carcinoma Subtypes of Advanced Adenocarcinoma

Cited by 8 publications

References 13 publications

Erlotinibversuscarboplatin and paclitaxel in advanced lepidic adenocarcinoma: IFCT-0504

Erlotinibversuscarboplatin and paclitaxel in advanced lepidic adenocarcinoma: IFCT-0504

Recurrent “pneumonia” in left lower lobe lasting for 8 years: a case report

Lung cancer: a rare indication for, but frequent complication after lung transplantation

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