First, adenocarcinoma or non-small cell carcinoma NOS should be tested for epidermal growth factor receptor (EGFR) mutations, as the presence of these mutations is predictive of response to EGFR tyrosine kinase inhibitors.6, 7 EGFR mutations are present in about 10% of adenocarcinomas, with higher rates among some patient subsets; in contrast, EGFR mutations are unlikely in squamous cell carcinomas. Second, adenocarcinoma histology is a strong predictor for improved outcome with pemetrexed therapy compared with squamous cell carcinoma; pemetrexed has led to improved survival for patients with nonsquamous cell lung cancer when given as first-line, second line, and maintenance therapy.8 Third, the risk of potentially life-threatening hemorrhage has been high when bevacizumab is used as part of treatment for squamous cell carcinoma.9 Thus, identifying the specific adenocarcinoma subtypes is crucial for selecting appropriate, effective, and safe treatment.
Learning Objectives After participating in this Webinar, participants should be able to ? Use uniform terminology and diagnostic criteria to identify adenocarcinoma of the lung, especially for bronchioalveloar carcinoma (BAC) ? Distinguish among adenocarcinoma, squamous cell carcinoma, and non-small cell carcinoma not otherwise specified using a variety of techniques ?Apply the new classification system to identify prognostic and predictive factors and therapeutic targets to facilitate the use of effective, safe treatment