TY - JOUR T1 - Should the treatment of advanced lepidic adenocarcinoma be adapted to the pathological subtype? JF - European Respiratory Journal JO - Eur Respir J SP - 1259 LP - 1261 DO - 10.1183/13993003.01563-2015 VL - 46 IS - 5 AU - Marianne Paesmans Y1 - 2015/11/01 UR - http://erj.ersjournals.com/content/46/5/1259.abstract N2 - In 2011, the pathological classification of lung adenocarcinoma was jointly revised by the International Association for the Study of Lung Cancer, the American Thoracic Society and the European Respiratory Society [1]. The former terminology adenocarcinoma with bronchiololalveolar features was recategorised as nonmucinous lepidic predominant adenocarcinoma (NM L-ADC) or mucinous variant (M L-ADC). The reason for this subclasssification was the identification of multiple differences: clinical, radiological, pathological and genetic. In particular, although bronchioloalveolar (BAC) features are overall an independent predictive factor for EGFR (epidermal growth factor receptor) mutation in a non-Asian population with an odds ratio of 2.84 (95% CI: 1.98–4.06) [2] compared with other types of lung adenocarcinoma, it was shown that NM tumours more frequently exhibit KRAS (Kirsten Ras) mutations and lack of EGFR mutations while M tumours are more likely to be EGFR mutated [3]. The creation of these two subcategories gives a rationale to investigate further whether the M or NM characteristic might be a new target for tailoring treatment of those patients with advanced lepidic adenocarcinoma.Increased sensitivity to chemotherapy/TKI of mucinous variant in advanced L-ADC should be tested in a phase III trial http://ow.ly/TkWXi ER -