Adenocarcinoma in situ and immunotherapy - 1271819

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3smidgets
Adenocarcinoma in situ and immunotherapy - 1271819

Are trials underway to use immunotherapy on adenocarcinoma in situ to prevent malignancy rather than waiting? I had a stage 1 nodule removed and have 12 more. It's impossible to resection them all. I have been advised to wait and watch.

catdander
Hi 3smidgets, I'm very sorry

Hi 3smidgets, I'm very sorry the cancer has returned. Adenocarcenoma in situ is the new name given to BAC. Dr. West is a leading specialist in that field and has written extensively on the subject, he also creates videos on the subject. Below is a quote addressing why it's not always appropriate to treat cancer if it's slow growing. He states, "And the fifth myth that I’d like to address is the idea that treatment should be started immediately or promptly. Now, I mentioned that the pace of BAC is quite variable: sometimes it’s extremely slow, sometimes it’s quite aggressive. In patients who have a very slow process, they can do very well and often have no symptoms for years on end. There are even patients who might never be affected and have their life limited by the cancer, even if it’s growing. If it’s growing by a few millimeters at a time it does not necessarily need treatment and patients might do well for 5 or 10 years or more." http://cancergrace.org/lung/2015/06/01/gcvl_lu-aa02_bac_myths_misconcept...

All the BAC/adeno in situ posts can be found here, http://cancergrace.org/lung/tag/adenocarcinoma-in-situ/

I hope you do well for a long time and cancer never becomes your leading health issue.

Janine

carrigallen
I agree. Generally, these

I agree. Generally, these BACs are often something that patients can live a full life without ever requiring systemic treatment, and often they do not die from it. The pace is different for everyone though.

Right now, there isn't much data to support commercial PD(L)1 drugs like Opdivo for BAC. We don't often see T-cells, PDL1, or inflammatory infiltrates around BACs. These in situ growths seem to largely fly under the radar of the immune system. So in theory, a PD(L)1 inhibitor given alone doesn't seem like it would do much. Still no one knows for sure yet, and we are still in the discovery phase here.

Generally, a recommended approach for multiple BACs is to do CT scans regularly, and if one of the lesions begins to transform into a solid, invasive tumor, to perform stereotactic radiation or resect it.