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Invasive mucinous adenocarcinoma is a type of lung cancer whose cells look like stomach or bowel lining and fill the air spaces with mucus, often appearing as pneumonia-like shadows on a scan. Most cases carry a KRAS mutation, and many of the rest carry a gene fusion, including NRG1, that new drugs can target.
The IASLC/ATS/ERS classification of 2011 separated invasive mucinous adenocarcinoma from the non-mucinous lepidic tumours because of its distinct cells (goblet or columnar with abundant mucin), its tendency to spread through the airways as multifocal or lobar consolidation, and its biology (Travis 2011). Sequencing of 72 cases found KRAS mutations in 63 percent, with a distribution of nucleotide changes closer to gastrointestinal than to other lung tumours; among the KRAS wild-type cases were the fusions CD74-NRG1, VAMP2-NRG1, TRIM4-BRAF, TPM3-NTRK1 and EML4-ALK and mutations in ERBB2 and other genes (Shim 2015). Expression profiling identified a 143-gene mucinous signature, shared with mucin-producing gastrointestinal, pancreatic and breast cancers, in which the transcription factors FOXA3, SPDEF and HNF4A drive MUC5AC and MUC5B, and in which the checkpoint VTCN1 rather than PD-L1 is expressed (EMBO Molecular Medicine 2017).
How it differs from its parent: it is TTF-1-negative and expresses gut markers, so it can be mistaken for a metastasis; it is EGFR-mutant only rarely; and it is the lung cancer richest in NRG1 fusions, for which the HER2-HER3 bispecific antibody zenocutuzumab is approved.
How common: no share is given in the sources read; it is a minority of adenocarcinomas.
Treatment: as lung adenocarcinoma by stage, with KRAS G12C inhibitors for that mutation, zenocutuzumab for NRG1 fusions, and the matching inhibitors for ALK, BRAF and NTRK fusions; multifocal disease that stays in the lung is sometimes resected repeatedly.
No registry share was found in the sources read.
Averages across everyone diagnosed, often years ago. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
Central tumours arise in the large airways, peripheral ones in the alveoli; both drain to hilar then mediastinal nodes, and the pleural lining is a separate cancer site.
Same organ: Mediastinal germ cell tumour, Pleuropulmonary blastoma (types I, Ir, II and III), Type A and type AB thymoma, Type B1 and type B2 thymoma, Type B3 thymoma, Micronodular thymoma with lymphoid stroma, Adenocarcinoma of the lung, Squamous cell carcinoma of the lung, Large cell carcinoma of the lung, Sarcomatoid carcinoma of the lung, Adenosquamous carcinoma of the lung, Adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung, Basaloid squamous cell carcinoma of the lung, Lymphoepithelial carcinoma of the lung, Pulmonary blastoma (adult), Non-small-cell lung cancer, Lung cancer (all types), Small-cell lung cancer, Mesothelioma, Pleural mesothelioma, Thymoma and thymic carcinoma, Childhood lung and airway tumours (pleuropulmonary blastoma, tracheobronchial tumours), Inflammatory myofibroblastic tumour (IMT), EGFR-mutated non-small-cell lung cancer, ALK-positive non-small-cell lung cancer, KRAS G12C-mutant non-small-cell lung cancer, ROS1-positive non-small-cell lung cancer, MET exon 14 and MET-amplified non-small-cell lung cancer, RET fusion-positive non-small-cell lung cancer, BRAF V600E-mutant non-small-cell lung cancer, HER2-mutant non-small-cell lung cancer, NTRK fusion-positive non-small-cell lung cancer, PD-L1-high non-small-cell lung cancer without a driver mutation, Resectable stage I to III non-small-cell lung cancer, Unresectable stage III non-small-cell lung cancer, Limited-stage small-cell lung cancer, Extensive-stage small-cell lung cancer, Lung neuroendocrine tumours (typical and atypical carcinoid), Thymoma (WHO types A, AB, B1, B2 and B3), Thymic carcinoma
Treated as lung adenocarcinoma by stage, with KRAS G12C inhibitors, zenocutuzumab for NRG1 fusions and matched inhibitors for other fusions when found.
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Query for this cancer: (TITLE:"Invasive mucinous adenocarcinoma of the lung" OR ABSTRACT:"Invasive mucinous adenocarcinoma of the lung" OR TITLE:"Invasive mucinous adenocarcinoma" OR ABSTRACT:"Invasive mucinous adenocarcinoma" OR TITLE:"IMA" OR ABSTRACT:"IMA" OR TITLE:"Mucinous bronchioloalveolar carcinoma term retired in 2011" OR ABSTRACT:"Mucinous bronchioloalveolar carcinoma term retired in 2011" OR TITLE:"Mucinous adenocarcinoma of the lung" OR ABSTRACT:"Mucinous adenocarcinoma of the lung") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Invasive mucinous adenocarcinoma of the lung, not a curated reading list.
The targets of this cancer's medicines and the ones linked to it directly.
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