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6 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.
Lung adenocarcinoma is the most common type of lung cancer and the form that non-smokers usually get; it starts in the mucus-making gland cells of the small airways, most often at the edge of the lung. It is the type in which testing for a driver mutation matters most, because half of cases have one that a tablet can target.
Adenocarcinoma is defined by glandular differentiation or mucin production, or by expression of the pneumocyte markers TTF-1 and napsin A in a poorly differentiated tumour. The IASLC/ATS/ERS classification of 2011, carried into the WHO classifications of 2015 and 2021, retired the terms bronchioloalveolar carcinoma and mixed subtype, introduced adenocarcinoma in situ and minimally invasive adenocarcinoma for small lepidic tumours, and classifies invasive tumours by predominant pattern (lepidic, acinar, papillary, micropapillary, solid) after recording the percentage of each; the 2021 edition adds a formal grading system built from those patterns, counts only the invasive component for T size, and recognises spread through air spaces as a prognostic feature (Travis 2011; Nicholson 2022). Invasive mucinous adenocarcinoma has its own page.
How it differs from its parent: the non-small-cell lung cancer page and its driver subpages describe treatment by mutation; this page is the histology in which those mutations concentrate. In 2,142 adenocarcinomas at Memorial Sloan Kettering, EGFR exon 19 deletions and L858R were found in 15 percent of tumours from former smokers and 6 percent from current smokers, with higher rates in never-smokers (NCI PDQ). The corpus's EGFR, ALK, ROS1, RET, MET, HER2, NTRK and KRAS G12C pages are, in practice, pages about adenocarcinoma.
| Setting | Approach | Guideline |
|---|---|---|
| Advanced, driver-negative | Pembrolizumab with platinum and pemetrexed (KEYNOTE-189), or the parent's PD-L1-high pathway when the score is 50 percent or more; datopotamab deruxtecan after chemotherapy (TROPION-Lung01). | not mapped |
| Advanced with a driver | Treated on the parent's driver pages (EGFR, ALK, ROS1, RET, MET, KRAS G12C, HER2, NTRK, BRAF). | not mapped |
| Early stage | Treated as the parent's resectable and stage III pages describe; histology does not change the surgery. | not mapped |