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4 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Adenosquamous carcinoma is an uncommon lung cancer that contains both gland-forming and squamous cancer cells, each making up at least a tenth of the tumour. It behaves worse than either pure type, but its gland-forming part often carries an EGFR mutation, so it is tested and treated like adenocarcinoma.
The WHO classification defines adenosquamous carcinoma as a carcinoma with at least 10 percent each of adenocarcinoma and squamous cell carcinoma, a diagnosis that can be made reliably only on a resection specimen; small biopsies usually capture one component (Li 2018). In the Japanese multi-institutional cohort adenosquamous cases had worse survival curves than adenocarcinoma or squamous cell carcinoma for all stages and for stage IA, IB and IIIA (Maeda 2012).
How it differs from its parent: it is the histology in which the treatment rules of adenocarcinoma and squamous cell carcinoma collide. The review evidence favours treating it as adenocarcinoma: EGFR mutations are frequent enough that EGFR inhibitors such as erlotinib and gefitinib are effective in EGFR-mutant advanced disease, platinum-based adjuvant chemotherapy for at least four cycles improved survival in stage III, data on ALK inhibitors are very limited, and checkpoint inhibitors are a potential option (Li 2018).
| Setting | Approach | Guideline |
|---|---|---|
| All stages | Treated as lung adenocarcinoma: driver testing, EGFR inhibitors when mutated, platinum-based chemotherapy with immunotherapy otherwise. | not mapped |