title: Salivary gland cancer: an update on present and emerging therapies.
abstract: Malignant salivary gland tumors make up a small proportion of malignancies worldwide, yet vary widely in terms of histology, patterns of spread, and recurrence. A better understanding of this variability will guide appropriate treatment recommendations and lead to improved outcomes. Recent molecular genetic studies have uncovered a translocation-generated gene fusion network in salivary gland carcinomas that can be used for diagnosis, treatment decisions, and development of specific targeted therapies. The gene fusions encode novel fusion oncoproteins that function as transcriptional coactivators, tyrosine kinase receptors, and transcription factors involved in growth-factor signaling and cell-cycle regulation. While surgery currently is the primary therapy for operable tumors, radiation plays an important role in the postoperative setting, as well as in the definitive setting for inoperable lesions. An awareness of the risk factors for tumor recurrence and spread is important for both adjuvant therapy referrals and for radiation treatment planning purposes. Additionally, chemotherapy is being used increasingly in both the concurrent setting as a radiosensitizer, as well as in the palliative setting for metastatic tumors. Future trials investigating concurrent chemotherapy and radiation, as well as the use of targeted agents based on evolving molecular discoveries, will elucidate optimal personalized approaches for this challenging disease.
authors.affiliation: From the Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO; Head and Neck Unit, Medical Oncology Department, Fondazione, IRCCS Istituto Tumori, Milan, Italy; Departments of Pathology and Oncology, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Julie
authors.initials: J
authors.lastname: Carlson
authors.forename: Lisa
authors.initials: L
authors.lastname: Licitra
authors.forename: Laura
authors.initials: L
authors.lastname: Locati
authors.forename: David
authors.initials: D
authors.lastname: Raben
authors.forename: Fredrik
authors.initials: F
authors.lastname: Persson
authors.forename: Göran
authors.initials: G
authors.lastname: Stenman
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003528:Carcinoma, Adenoid Cystic / Q000235:genetics / Q000473:pathology / Q000628:therapy; D018277:Carcinoma, Mucoepidermoid / Q000235:genetics / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy / Q000379:methods; D006801:Humans; D058990:Molecular Targeted Therapy / Q000379:methods; D009154:Mutation; D009364:Neoplasm Recurrence, Local; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D011379:Prognosis; D012468:Salivary Gland Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology / Q000628:therapy*
chemical_list: D015514:Oncogene Proteins, Fusion