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| |  Research Explores Lung Cancer Among Paediatric Cancer Patients ]WASHINGTON, DC -- November 3, 2010 -- Through an assessment of clinical, tissue-based, and molecular data for paediatric lung cancer, research published in the November edition of the Journal of Thoracic Oncology determined that pulmonary lesions found in young patients with paediatric cancers can be histologically indistinguishable from lung adenocarcinoma seen in adults. Findings indicate that lung adenocarcinomas could occur prior to chemotherapy treatment for a second cancer, and some tumours display gene mutations in EGFR and KRAS. This is the first documentation of these mutations in paediatric adenocarcinoma. Until now, it had seemed reasonable to consider these rare pulmonary tumours as secondary malignancies in children, caused by treatment for other cancers. In this newly published study, however, the tumours of 8 patients aged 10 to 24 years, all never smokers, were evaluated in terms of histopathologic and molecular data. Researchers determined that these tumours are (1) adenocarcinomas ranging from bronchioloalveolar carcinoma (BAC), or adenocarcinoma in situ (AIS), to invasive histologic patterns and (2) may be present before administration of chemotherapy for the underlying malignancy, and therefore are not always or necessarily secondary malignancies, as had been previously believed. The study clearly documents the invasive patterns of lung cancer in paediatric cancer patients and suggests that the simultaneous presence of a primary malignancy and pulmonary adenocarcinoma may reflect more than coincidence. “In the past, because of the unusually young age, we were reluctant to call such tumours ‘BAC’ and instead qualified these cases as BAC-like nodule,” explained lead investigator Marc Ladanyi, MD, Memorial Sloan-Kettering Cancer Center, New York, New York. “Our findings now confirm the presence of EGFR and KRAS mutations in some of these paediatric lung cancers in a proportion similar to lung cancers seen in adults, which allows us to more confidently propose that this is genuine lung cancer in the paediatric population.” “The clinical course of these lung adenocarcinomas in children remains unclear because all 8 patients had their lung tumours fully removed without subsequent recurrence,” he said. “This may reflect the fact that half of the patients had AIS, which is now recognised to have a 100% disease-free survival for completely resected cases. An open question is whether these lung adenocarcinomas are increasing in the paediatric age group or is this due to a detection bias due to more detailed lung imaging in patients with common, non-pulmonary, childhood cancers.” SOURCE: International Association for the Study of Lung Cancer
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