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What I Really Do: BAC and Slowly Progressing Cancers

August 27, 2008 - 5:03 pm

   In the last few years BAC has become increasingly studied and recognized as a distinct clinical subtype of lung cancer.  The classic BAC syndrome is characterized by progression limited to the lungs, and its growth can be quite variable.  The definition of BAC based on pathology has been applied pretty variably: although it should […]

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Actions Speak Louder than Words: When Pathology and the Clinical Picture Don’t Fit

August 13, 2008 - 7:54 pm

   I’ve been involved in a wide range of discussions, both here and in my own clinical, about the fairly common situation of how to approach a situation in which the story on paper and what you see actually happening are incompatible.  For instance, last week I and several of my colleagues participated in a […]

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Longterm Survival with Iressa in BAC

June 25, 2008 - 9:22 pm

One of my earliest posts when I started OncTalk was on the use of oral inhibitors of the epidermal growth factor receptor (EGFR), one of the growth signals that is often over-active in cancer cells, against advanced bronchioloalveolar carcinoma (BAC), a unique subtype of lung cancer that tends to grow within the […]

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Biomarkers Predicting Clinical Benefits for BAC Patients Receiving Tarceva

April 30, 2008 - 9:35 pm

   Continuing with the analysis of a publication about tarceva (erlotinib) for patients with advanced BAC that I introduced in the last post, we’ll turn now to the analysis that Dr. Vince Miller and colleagues did on the biomarkers that might predict more or less clinical benefit with an EGFR inhibitor like tarceva (abstract here).   The trial looked at three […]

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Trial of Tarceva in BAC: New Info on Who Benefits with Tarceva

April 29, 2008 - 3:49 pm

   In a recent issue of the Journal of Clinical Oncology, Dr. Vince Miller and colleagues published the results of an important trial of the EGFR inhibitor tarceva (erlotinib) in the unusual NSCLC subtype bronchioloalveolar carcinoma, or BAC (abstract here).   This work was predicated on the observation, also by Dr. Miller and his colleagues at Memorial […]

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Surgery for BAC: Special Considerations

December 10, 2007 - 11:08 pm

   While there is a lot of variability in the clinical behavior of bronchioloalveolar carcinoma (BAC), there are some commonly observed findings that are now leading lung cancer experts to consider it as a distinct clinical entity worthy of special consideration for management.  Among the important areas for potentially special clinical management is in surgical management of […]

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Noguchi Classification of Bronchioloalveolar Carcinoma (BAC)

December 8, 2007 - 10:55 pm

   I had previously written about a spectrum from pure bronchioloalveolar carcinoma (BAC) to invasive adenocarcinoma in one of my first posts here, but the real credit for this concept goes back to Dr. Masayuki Noguchi from the National Cancer Center Hospital in Tokyo, Japan, who characterized a classification system for peripheral lung adenocarcinomas back […]

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Japanese Variant on Adjuvant Chemotherapy: The Story of UFT

October 22, 2007 - 10:33 pm

   Throughout multiple discussions of adjuvant chemotherapy, I’ve focused on the traditional approach used in the US and Europe of 3-4 cycles of platinum-based chemo, treating for up to about three months with a rather intensive approach.  However, in Japan, they’ve studied the value of a different form of adjuvant treatment, with a drug called […]

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PET Scans for BAC

October 20, 2007 - 8:53 pm

   PET scans are an important way to discriminate between metabolically active nodules, suggestive of cancer but sometimes representing inflammation or infection, and non-PET-avid lesions that are felt much likely to represent cancer. They are also a cornerstone of “clinical” staging by imaging and patient exam (vs. “pathologic” staging by surgery to clarify where cancer […]

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A Few New Trials for Never-Smokers and Patients with BAC

October 8, 2007 - 3:39 pm

   Several trials have recently opened up for never-smokers with any lung adenocarcinoma or those with BAC (or adeno/BAC mix, invasive adenocarcinoma with BAC features) with any smoking status.  Both of these groups have only recently gained recognition as likely being a distinct clinical entity with a different natural history (clinical behavior outside of treatment) […]

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