UNASSIGNED: e21135 Background: Lung adenocarcinoma (ADC) has variegated histology and diverse clinical behavior. The 2011 IASLC classification of lung ADC recognizes distinctive architectural types but cytological features and @entity5 stromal responses may also be useful for prognosis. The predictive value of these features in relation to @entity3866 treatment is unknown. The objectives were to develop a tool for detailed morphologic profiling of lung ADC and to identify potential features related to outcome in a cohort of @entity1 (pts) with advanced NSCLC treated with @entity3866 . METHODS: This was a retrospective study of resected lung ADC from pts with advanced NSCLC treated with @entity3866 (N=51). Subtyping of resected ADC was adapted from morphometric profiling using hierarchical clustering (Okudela 2008). @entity5 -associated fibrotic (TAFR) and lymphoid responses (TALR) were graded on H_E sections as prominent vs mild/none. The log-rank test was used to compare selected morphologic parameters for their effects on overall (OS) and progression-free survival (PFS). RESULTS: 51 pts included 29 females, 8 never smokers, and 8 with @entity470 activating gene mutations. ADC with prominent TAFR (N=33) showed a significant difference for improved PFS (p=0.002) vs with those without (N=5), but no difference in OS. No significant differences in survival were found between mixed vs pure ADC types, mixed type with solid pattern vs without, mixed subtype with high columnar cell type vs without, and prominent TALR vs none. CONCLUSIONS: This is a small, retrospective study but our data show that prominent TAFR is related to improved PFS in advanced ADC pts treated with @entity3866 . This suggests that altered @entity5 microenvironment may be an important effect of @entity3866 therapy. Our data suggest that @entity5 cytologic changes and TALR are not important for survival in advanced stage pts. Detailed morphologic subtyping of ADC and @entity5 stromal responses will be validated in early stage ADC for prognostic markers and may be useful in predicting improved PFS in @entity470 mutation-negative ADC @entity1 receiving @entity3866 .

Histologic subtyping and XXXX stromal responses in advanced-stage lung adenocarcinoma and their relationship to survival.

@entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'Tumor'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity3866 :: ('MESH:C400278', 'Chemical') :: ['erlotinib'] @entity470 :: ('1956', 'Gene') :: ['EGFR']
@entity5 :: (MESH:D009369,Disease) :: ['tumor']
