Salivary gland tumors: Molecular characterization and therapeutic advances for metastatic disease

Schvartsman, Gustavo; Pinto, Nathalia Almeida; Bell, Diana; Ferrarotto, Renata

doi:10.1002/hed.25468

Cited by 25 publications

(17 citation statements)

References 96 publications

(111 reference statements)

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“…Anti-HER2 therapy has become the preferred therapy for those with HER2 overexpression or amplification of the ErB-B2 gene [9]. The combination of anti-HER2 trastuzumab with docetaxel was found to be promising in a single-center phase II study of 57 patients that achieved an overall response rate of 70.2% with an overall survival of 39.7 months [10].…”

Section: Discussionmentioning

confidence: 99%

Combination Chemohormonal Therapy in Metastatic Salivary Duct Carcinoma

et al. 2020

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Objective: Rare disease Background: Salivary duct carcinoma (SDC) is a rare, aggressive head and neck cancer with frequent metastases. Current treatment options for recurrent or metastatic SDC include targeted anti-androgen therapy, HER2-targeted therapy, or systemic chemotherapy. We report the first use of a combination chemohormonal strategy. Case Report: A 68-year-old male who had never smoked with a past medical history of two-vessel coronary artery disease and systolic heart failure presented with a parotid mass and underwent surgical resection. Biopsy of the mass revealed high-grade, androgen receptor-positive and Erb-B2 receptor tyrosine kinase-2 (ERBB2)-amplified positive SDC. He subsequently received adjuvant radiation therapy. Four months after completion of adjuvant radiation therapy, recurrence with symptomatic pleural effusion and nodes, hepatic metastases, and boney metastases occurred. Due to significant symptomatic tumor, a rapid treatment response was desired. Combination chemohormonal therapy (CHT) was initiated with carboplatin area under the curve 4 and paclitaxel, 200 mg/m 2 in 21day cycles along with combined androgen blockade using leuprolide, 45 mg subcutaneously every 6 months and bicalutamide, 50 mg daily. The treatment was well tolerated with fatigue as the main adverse event. Positron emission tomography-computed tomography at 3 and 6 months after treatment initiation showed good partial response. The patient experienced uveal progression after 8 months and alternate treatment was started. Conclusions: Combination CHT with carboplatin, paclitaxel, and combined androgen deprivation may be a good treatment option in androgen receptor-positive recurrent or metastatic SDC if rapid treatment response is desired. Combination chemotherapy with androgen deprivation for validation through clinical trials.

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Section: Discussionmentioning

confidence: 99%

Combination Chemohormonal Therapy in Metastatic Salivary Duct Carcinoma

et al. 2020

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“…In terms of therapeutic management, when confronted with the over 20 primary malignant tumors described in the latest WHO classification, it is currently accepted that response to CHT is histotype‐specific . Platinum‐based polychemotherapy is superior to monotherapy against ACC whereas paclitaxel or gemcitabine are active against adenocarcinoma or MEC . However, oncological results of conventional regimens remain disappointing and the same is true for newer cytotoxic drugs .…”

Section: Discussionmentioning

confidence: 99%

“…36,37 Platinum-based polychemotherapy is superior to monotherapy against ACC whereas paclitaxel or gemcitabine are active against adenocarcinoma or MEC. 36,38 However, oncological results of conventional regimens remain disappointing and the same is true for newer cytotoxic drugs. 36 In addition, given the relative indolent nature of most metastatic lesions, most oncologists agree to initiate CHT only in face of symptomatic or rapidly progressing disease.…”

Section: Discussionmentioning

confidence: 99%

A nomogram to estimate the risk of developing distant metastases in parotid cancer

et al. 2019

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Background Parotid cancer (PC) is a heterogeneous group of malignant tumors whose management mainly focuses on locoregional control. However, distant metastases (DM) can represent the most common cause of treatment failure. We have defined the predictors and developed a model that can predict a single patient's risk to develop DM. Methods We have analyzed our institutional database of 259 patients with PC and use it to develop a nomogram. C‐index and calibration curves were used to assess performance of our model. Results DM appeared in 18.9% of patients. Age, cT, pN, perineural invasion, and adenoid cystic carcinoma were significantly associated with distant failure. Conclusions We here present the first model to identify patients with PC at high risk of DM. Such tool can be of great value in managing these rare cancers in terms of a more precise prognosis and follow‐up while waiting for better systemic therapies to come in the future.

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“…The rarity of SDC has made it impossible to conduct large definitive randomized trials to establish standard approaches to treatment. The current treatment options and trends for patients with SDC have been reviewed by various researchers 83‐87 . Because there is a considerable variety in the treatment of SDC between institutions, we herein mainly discuss the contents of the recent updates to the National Comprehensive Cancer Network (NCCN) guidelines 56 .…”

Section: Treatmentmentioning

confidence: 99%

Salivary duct carcinoma: Updates in histology, cytology, molecular biology, and treatment

Nakaguro

Tada

Faquin

et al. 2020

Cancer Cytopathology

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Salivary duct carcinoma (SDC) is an aggressive subtype of primary salivary gland carcinoma, often with an advanced stage at presentation and high rates of metastasis and recurrence. It most commonly arises in the parotid gland of older men and microscopically resembles high-grade breast ductal carcinoma. While 50 years have lapsed since the first report of this entity, recent intensive studies have shed light on its biologic, genetic, and clinical characteristics. The diagnosis of SDC is aided by the immunohistochemical expression of androgen receptor (AR) coupled with its characteristic histomorphology. Fine-needle aspiration typically reveals cytologic features of high-grade carcinoma, and ancillary studies using cell block material can facilitate the specific diagnosis of SDC. In surgical specimens, certain histologic features are important prognostic factors, including nuclear pleomorphism, mitotic counts, vascular invasion, and the morphology at the invasion front. Several clinical studies have shown promising results using targeted therapy for AR and human epidermal growth factor receptor 2 (HER2), and the latest version of the National Comprehensive Cancer Network guidelines recommends the evaluation of AR and HER2 status before treatment. Recent molecular analyses have revealed multiple heterogeneous alterations in wellknown oncogenes and tumor suppressor genes, including TP53, HRAS, PIK3CA, PTEN, and BRAF. Clinical trials of drugs targeting these genes may broaden the treatment options for SDC in the near future.

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Salivary gland tumors: Molecular characterization and therapeutic advances for metastatic disease

Cited by 25 publications

References 96 publications

Combination Chemohormonal Therapy in Metastatic Salivary Duct Carcinoma

Combination Chemohormonal Therapy in Metastatic Salivary Duct Carcinoma

A nomogram to estimate the risk of developing distant metastases in parotid cancer

Salivary duct carcinoma: Updates in histology, cytology, molecular biology, and treatment

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