Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Oncology, Nijmegen, the Netherlands.
Radboud University Medical Center, Department of Human Genetics, Nijmegen, the Netherlands; Radboud University Medical Center, Department of Pathology, Nijmegen, the Netherlands.
Cancer Treat Rev. 2019 Nov;80:101906. doi: 10.1016/j.ctrv.2019.101906. Epub 2019 Oct 14.
Salivary gland cancer (SGC) is a rare malignancy consisting of 22 subtypes with different genetic, histological and clinical characteristics. This rarity and heterogeneity makes systemic treatment of recurrent or metastatic (R/M) disease challenging. Use of chemotherapy is scarcely studied and chemotherapy at best has moderate effects. New therapeutic strategies are therefore warranted, but advances made in SGC are lagging behind on advances made in more common cancers. By unraveling tumor characteristics of SGC, such as genetic alterations and protein expression profiles, therapeutic strategies tailored to the patient's tumor can be rationalized. This genomic profiling and mapping of immunohistochemical expression profiles is essential in the search for a suitable treatment approach. Thereby, it alleviates the paucity in systemic treatment options and can significantly alter the prognosis of patients with R/M SGC. This review aims to give a comprehensive overview of known genetic alterations and expression profiles amenable for targeted therapy in every histological subtype of SGC. We discuss the remaining knowledge gaps and the implications of these targets for future studies and personalized treatments, thereby aiding clinicians faced with this rare and heterogeneous type of cancer.
唾液腺癌（SGC）是一种罕见的恶性肿瘤，由 22 种不同遗传、组织学和临床特征的亚型组成。这种罕见性和异质性使得复发性或转移性（R/M）疾病的系统治疗具有挑战性。化疗的应用研究甚少，而且化疗的效果充其量只是中等。因此，需要新的治疗策略，但 SGC 的进展落后于更常见癌症的进展。通过揭示 SGC 的肿瘤特征，如遗传改变和蛋白表达谱，可以合理化针对患者肿瘤的治疗策略。这种基因组分析和免疫组织化学表达谱的映射对于寻找合适的治疗方法至关重要。这减轻了系统治疗方案选择的不足，并可显著改变 R/M SGC 患者的预后。本综述旨在全面概述 SGC 的每种组织学亚型中适合靶向治疗的已知遗传改变和表达谱。我们讨论了这些靶点的剩余知识空白及其对未来研究和个性化治疗的影响，从而为面临这种罕见和异质性癌症的临床医生提供帮助。
