Oncology Department, Hôpitaux Paris, Saint-Joseph Marie-Lannelongue, Paris; Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Epinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2 Institute de Neurologie, Paris.
Oncology Department, Hôpitaux Paris, Saint-Joseph Marie-Lannelongue, Paris.
ESMO Open. 2024 Oct;9(10):103722. doi: 10.1016/j.esmoop.2024.103722. Epub 2024 Oct 4.
Salivary gland cancers are infrequent and pose a challenge owing to their histological diversity and varied clinical behavior, making the selection of optimal systemic treatments for advanced or recurrent stages difficult. This systematic review aims to assess overall survival outcomes and systemic treatment responses across four types of salivary cancers.
A PubMed and Google Scholar search identified studies involving initially advanced or relapsed cases undergoing systemic treatment. Studies with clear, individualized data on treatment responses and outcomes were selected based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Of the 723 studies screened, 44 met our inclusion criteria.
A total of 426 cases of recurrent/metastatic salivary gland cancer, mostly salivary duct carcinoma (SDC; n = 219) and adenoid cyst carcinoma (ACC; n = 167), were included. Histomolecular markers were heavily associated with histology, with HER2 overexpression and androgen receptor nuclear expression typically found in SDC and adenocarcinoma not otherwise specified cases and KIT overexpression only in ACC. The response rates were associated with specific receptor blockage, with trastuzumab plus chemotherapy, and bicalutamide being the most effective (overall response rate 80% and 42.8%, respectively). Moreover, the response to treatment positively influenced overall survival (responders 38 versus non-responders 18.7 median months; P < 0.001). In this retrospective analysis of a particular cohort, survival outcomes per histology types showed that anti-human epidermal growth factor receptor 2 therapy was more effective for SDC, while chemotherapy was more effective for ACC.
Systemic treatments contribute to the survival of patients with salivary gland cancer at relapsed or newly advanced stages. The response to treatment is heavily influenced by histological subtype and treatment specificity.
唾液腺癌较为罕见，由于其组织学多样性和不同的临床行为，给治疗带来了挑战，使得选择最佳的系统治疗方案来治疗晚期或复发性疾病变得困难。本系统评价旨在评估四种唾液腺癌的总生存结果和系统治疗反应。
通过 PubMed 和 Google Scholar 检索，确定了涉及接受系统治疗的初诊晚期或复发病例的研究。根据系统评价和荟萃分析的首选报告项目（PRISMA）清单，选择了具有明确、个体化的治疗反应和结局数据的研究。在筛选的 723 项研究中，有 44 项符合我们的纳入标准。
共纳入 426 例复发性/转移性唾液腺癌病例，主要为涎管癌（SDC；n=219）和腺样囊性癌（ACC；n=167）。组织分子标志物与组织学密切相关，HER2 过表达和雄激素受体核表达通常见于 SDC 和非特指腺癌，KIT 过表达仅见于 ACC。反应率与特定受体阻断有关，曲妥珠单抗联合化疗的效果最显著（总反应率分别为 80%和 42.8%）。此外，治疗反应对总生存有积极影响（反应者为 38 个月，无反应者为 18.7 个月；P<0.001）。在这项对特定队列的回顾性分析中，根据组织学分型，生存结果显示抗人表皮生长因子受体 2 治疗对 SDC 更有效，而化疗对 ACC 更有效。
系统治疗有助于复发性或新进展期唾液腺癌患者的生存。治疗反应受组织学亚型和治疗特异性的影响较大。
