Bronchoalveolar Carcinoma (BAC), a unique subtype of lung cancer, has increasingly drawn the spotlight in the oncology field, given its distinctive radiological and pathological features. Protheragen is committed to offering all-encompassing services for the development of diagnostic tools and therapeutic solutions targeting bronchoalveolar carcinoma (BAC).
Overview of Bronchoalveolar Carcinoma (BAC)
Bronchoalveolar Carcinoma (BAC) is a unique subtype of lung adenocarcinoma, distinguished by its particular clinical and pathological traits. This type of cancer is marked by tumor cells proliferating along the alveolar septa, without invading the stroma, blood vessels, or pleura. BAC frequently occurs in never-smokers, women, and individuals of Japanese descent. However, the precise molecular mechanisms underlying these predispositions are still not fully understood. In terms of presentation, BAC can manifest as a solitary nodule, multiple synchronous nodules, or a diffuse parenchymal process. Often, it is asymptomatic at the time of diagnosis and is commonly detected incidentally through chest radiography or CT scans.
Fig.1 Proposed revisions to the classification of residual tumor in lung cancer. (Detterbeck F. C..,
et al., 2024)
Pathogenesis of Bronchoalveolar Carcinoma (BAC)
The pathogenesis of BAC is thought to adhere to a multistep model akin to those well-documented in colon and breast cancer, which posits that the sequential accumulation of genetic mutations culminates in the emergence of an invasive phenotype. BAC is regarded as a carcinoma in situ due to its lack of invasion into blood vessels, lymphatics, or mesenchymal tissues. Clinical and experimental data support the progression sequence from atypical adenomatous hyperplasia (AAH) to BAC and subsequently to invasive adenocarcinoma. Moreover, the existence of bronchioalveolar stem cells, capable of differentiating into both bronchiolar and alveolar cells, points to these cells as potential precursors of BAC. The differentiation trajectory of these transformed stem cells hinges on dominant mutations that shape the tumor cell environment.
Diagnostics Development for Bronchoalveolar Carcinoma (BAC)
Molecular markers, like EGFR mutations, are progressively gaining traction in the diagnosis and prognosis of BAC. EGFR mutations are more prevalent in BAC compared to other lung cancer histologies and are linked to a better response to EGFR-TKIs. In addition to EGFR, other molecular markers such as p53, K-ras, and survivin are also under investigation for their potential contributions to the diagnosis and prognosis of BAC.
Histopathological Examination
Unlike other lung cancer subtypes, BAC necessitates histologic assessment to determine the presence or absence of invasion. Fine-needle aspiration cytology is not sufficiently sensitive for diagnosing BAC, and intraoperative frozen-section histology falls short in both sensitivity and specificity. Consequently, surgical resection followed by comprehensive histopathological analysis is frequently required to establish a conclusive diagnosis.
Therapeutics Development for Bronchoalveolar Carcinoma (BAC)
- Systemic Therapies
Systemic therapy for advanced BAC has historically been considered less effective, but recent studies suggest that chemotherapy can have some benefit. Two small prospective trials of chemotherapy in patients with advanced BAC reported partial responses to paclitaxel of 11 and 14%.
- Targeted Therapies
Targeted therapies, particularly EGFR-TKIs like gefitinib and erlotinib, have shown significant promise in treating BAC, especially in patients with specific EGFR mutations. In clinical trials evaluating the use of gefitinib in advanced NSCLC, the response rate among patients with BAC was 38%, compared with just 14% for patients with non-BAC adenocarcinomas.
- Emerging Therapiesbr>Emerging therapies include autologous tumor vaccines and proteosome inhibitors. For example, CG8123 (GVAX) is an autologous vaccine created by modifying harvested tumor cells to secrete granulocyte macrophage colony-stimulating factor.
Table 1. Therapeutics of Bronchoalveolar Carcinoma (BAC).
| Therapeutics |
Drug Name |
Target |
Description |
Stage |
| Systemic Chemotherapy |
Paclitaxel |
Tumors |
Used in advanced BAC with reported partial responses of 11-14%. |
Approved |
| Targeted Therapy |
Gefitinib |
Epidermal Growth Factor Receptor (EGFR) |
EGFR-TKI, effective in BAC with a response rate of 38% in BAC cases. |
Phase II |
| Targeted Therapy |
Erlotinib |
Epidermal Growth Factor Receptor (EGFR) |
EGFR-TKI, with a response rate of 24% in BAC cases. |
Phase II |
Disclaimer: Protheragen focuses on providing preclinical research services. This table is for information exchange purposes only. This table is not a treatment plan recommendation. For guidance on treatment options, please visit a regular hospital.
Our Services
Protheragen understands that every research project has its own distinct needs. To address these specific requirements, we offer customized services. Our team of experts collaborates closely with clients to design and implement bespoke solutions for the development of BAC diagnostics and therapeutics. Whether it involves developing a particular molecular marker or refining a targeted therapy, Protheragen delivers adaptable and innovative services to support the unique objectives of each project.
Disease Models
- Clara Cells
- Mucin-Producing Cells
- Alveolar Type II Epithelial Cells
- Patient-Derived Organoids
- Patient-Derived Tumor Xenograft (PDX) Models
Protheragen's services for BAC diagnostics and therapeutics development are distinguished by their holistic and integrated nature. We have meticulously crafted our offerings to provide robust support across the entire research and development continuum, encompassing early-stage discovery, preclinical evaluation, and extending well beyond. If you are interested in our services, please feel free to contact us.
References
- Detterbeck, Frank C., et al. "The International Association for the Study of Lung Cancer lung cancer staging project: proposals for revision of the classification of residual tumor after resection for the forthcoming (ninth) edition of the TNM Classification of Lung Cancer." Journal of Thoracic Oncology 19.7 (2024): 1052-1072.
- Raz, Dan J., Jae Y. Kim, and David M. Jablons. "Diagnosis and treatment of bronchioloalveolar carcinoma." Current opinion in pulmonary medicine 13.4 (2007): 290-296.
All of our services and products are intended for preclinical research use only and cannot be used to diagnose, treat or manage patients.
