Yoon Jin Cha1, Hye Ryun Kim2, Hye-Jeong Lee3, Byoung Chul Cho2, Hyo Sup Shim4. 1. Department of Pathology, Severance Hospital, Yonsei University College of Medicine, South Korea. 2. Department of Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, South Korea. 3. Department of Radiology, Severance Hospital, Yonsei University College of Medicine, South Korea. 4. Department of Pathology, Severance Hospital, Yonsei University College of Medicine, South Korea. Electronic address: shimhs@yuhs.ac.
Abstract
INTRODUCTION: An invasive mucinous adenocarcinoma (IMA) is a distinct lung adenocarcinoma variant. The characteristics of stage IV IMAs are relatively unclear since most previous studies described resected cases from stage I to III. The present study aimed to investigate the clinical course of stage IV IMAs and compare the findings to those of stage IV invasive non-mucinous adenocarcinomas (INMAs). METHODS: The study included 36 IMA patients and 210 INMA patients. The clinicopathological parameters, treatment methods and responses, overall survival (OS), and progression-free survival (PFS) were evaluated. RESULTS: IMAs were predominantly located in the lower lobes and frequently presented with multifocal consolidation and lung-to-lung or pleural metastasis. KRAS mutations were noted in 60.0% of the examined IMAs. Non-TKI chemotherapy (CTx) was used in 72.2% of the IMA patients. OS was significantly better in untreated IMA patients than in untreated INMA patients. IMA patients treated with non-TKI CTx had no improvement of OS compared to the untreated IMA patients. However, among INMA patients, OS was best with TKIs in patients harbouring targetable mutations, followed by non-TKI CTx. IMA and INMA patients treated with non-TKI CTx had similar PFS. CONCLUSIONS: Stage IV IMAs have distinct clinicopathological characteristics, and they might be less aggressive than INMAs. Since non-TKI CTx might not be beneficial in IMA patients, new therapeutic approach is necessary.
INTRODUCTION: An invasive mucinous adenocarcinoma (IMA) is a distinct lung adenocarcinoma variant. The characteristics of stage IV IMAs are relatively unclear since most previous studies described resected cases from stage I to III. The present study aimed to investigate the clinical course of stage IV IMAs and compare the findings to those of stage IV invasive non-mucinous adenocarcinomas (INMAs). METHODS: The study included 36 IMA patients and 210 INMA patients. The clinicopathological parameters, treatment methods and responses, overall survival (OS), and progression-free survival (PFS) were evaluated. RESULTS: IMAs were predominantly located in the lower lobes and frequently presented with multifocal consolidation and lung-to-lung or pleural metastasis. KRAS mutations were noted in 60.0% of the examined IMAs. Non-TKI chemotherapy (CTx) was used in 72.2% of the IMA patients. OS was significantly better in untreated IMA patients than in untreated INMA patients. IMA patients treated with non-TKI CTx had no improvement of OS compared to the untreated IMA patients. However, among INMA patients, OS was best with TKIs in patients harbouring targetable mutations, followed by non-TKI CTx. IMA and INMA patients treated with non-TKI CTx had similar PFS. CONCLUSIONS: Stage IV IMAs have distinct clinicopathological characteristics, and they might be less aggressive than INMAs. Since non-TKI CTx might not be beneficial in IMA patients, new therapeutic approach is necessary.
Authors: Alexander Drilon; Natasha Rekhtman; Jason C Chang; Michael Offin; Christina Falcon; David Brown; Brian R Houck-Loomis; Fanli Meng; Vasilisa A Rudneva; Helen H Won; Sharon Amir; Joseph Montecalvo; Patrice Desmeules; Kyuichi Kadota; Prasad S Adusumilli; Valerie W Rusch; Sarah Teed; Joshua K Sabari; Ryma Benayed; Khedoudja Nafa; Laetitia Borsu; Bob T Li; Alison M Schram; Maria E Arcila; William D Travis; Marc Ladanyi Journal: Clin Cancer Res Date: 2021-05-04 Impact factor: 12.531
Authors: Alexander Drilon; Michael Duruisseaux; Ji-Youn Han; Masaoki Ito; Christina Falcon; Soo-Ryum Yang; Yonina R Murciano-Goroff; Haiquan Chen; Morihito Okada; Miguel Angel Molina; Marie Wislez; Philippe Brun; Clarisse Dupont; Eva Branden; Giulio Rossi; Alexa Schrock; Siraj Ali; Valérie Gounant; Fanny Magne; Torsten Gerriet Blum; Alison M Schram; Isabelle Monnet; Jin-Yuan Shih; Joshua Sabari; Maurice Pérol; Viola W Zhu; Misako Nagasaka; Robert Doebele; D Ross Camidge; Maria Arcila; Sai-Hong Ignatius Ou; Denis Moro-Sibilot; Rafael Rosell; Lucia Anna Muscarella; Stephen V Liu; Jacques Cadranel Journal: J Clin Oncol Date: 2021-06-02 Impact factor: 50.717