Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
Expert Rev Anticancer Ther. 2024 Jul;24(7):567-580. doi: 10.1080/14737140.2024.2357806. Epub 2024 Jun 4.
Adenoid cystic carcinoma of minor salivary glands (AdCCmSG) represents a 'rarity in the rarity,' posing a clinical challenge in lack of standardized, evidence-based recommendations. At present, AdCCmSG management is mostly translated from major salivary gland cancers (MSGCs). Ideally, AdCCmSG diagnostic-therapeutic workup should be discussed and carried out within a multidisciplinary, high-expertise setting, including pathologists, surgeons, radiation oncologists and medical oncologists.
The present review provides an overview of epidemiology and pathologic classification. Moreover, the most recent, clinically relevant updates in the treatment of AdCCmSG (Pubmed searches, specific guidelines) are critically discussed, aiming to a better understanding of this rare pathologic entity, potentially optimizing the care process, and offering a starting point for reflection on future therapeutic developments.
The management of rare cancers is often hindered by limited data and clinical trials, lack of evidence-based guidelines, and hardly represented disease heterogeneity, which cannot be successfully tackled with a 'one-size-fits-all' approach. Our goal is to address these potential pitfalls, providing an easy-to-use, updated, multidisciplinary collection of expert opinions concerning AdCCmSG management as of today's clinical practice. We will also cover the most promising future perspectives, based on the potential therapeutic targets highlighted within AdCCmSG's molecular background.
小唾液腺腺样囊性癌(AdCCmSG)是一种“罕见中的罕见”,由于缺乏标准化的循证推荐意见,给临床带来了挑战。目前,AdCCmSG 的治疗主要是从大唾液腺癌(MSGC)转化而来。理想情况下,AdCCmSG 的诊断-治疗检查应在多学科、高专业知识的环境中进行,包括病理学家、外科医生、放射肿瘤学家和肿瘤内科医生。
本综述概述了流行病学和病理分类。此外,还对 AdCCmSG 治疗方面的最新、最具临床相关性的更新(Pubmed 检索、具体指南)进行了批判性讨论,旨在更好地了解这一罕见的病理实体,有可能优化护理流程,并为未来的治疗发展提供思考的起点。
罕见癌症的管理往往受到数据和临床试验有限、缺乏循证指南以及疾病异质性难以代表的阻碍,因此不能通过“一刀切”的方法成功解决。我们的目标是解决这些潜在的陷阱,提供一种易于使用、更新的、多学科的专家意见集合,用于当今临床实践中 AdCCmSG 的管理。我们还将根据 AdCCmSG 分子背景中强调的潜在治疗靶点,涵盖未来最有前途的前景。