title: Metastatic Salivary Gland Tumors: A Single-Center Study Demonstrating the Feasibility and Potential Clinical Benefit of Molecular-Profiling-Guided Therapy.
abstract: We evaluated the use of molecular profiling (MP) for metastatic salivary gland adenoid cystic carcinoma (SACC), for which there is no standard treatment. MP (Caris Molecular Intelligence) was performed on biopsy samples from all metastatic SACC patients attending a tertiary medical center between 2010 and 2013 (n = 14). Treatment was selected according to the biomarkers identified. Findings were compared with all similarly diagnosed patients treated in the same center between 1996 and 2009 (n = 9). For each patient, MP identified 1-13 biomarkers associated with clinical benefit for specific therapies (most commonly low/negative TS, low ERCC1). Eleven patients (79%) received MP-guided treatment (2 died prior to treatment initiation, 1 opted not to be treated), with complete response in 1, partial response (PR) in 3, and stable disease in 4. In the historical controls, 2 patients (22%) were treated (1 had PR). Median (range) progression-free survival in the first line after MP was 8.2 months (1.4-49.5+). Median (range) overall survival from diagnosis of metastatic disease was 31.3 (1.4-71.1+) versus 14.0 (1.5-116) months in the historical controls. In conclusion, MP expands treatment options and may improve clinical outcomes for metastatic SACC. In orphan diseases where randomized trials cannot be performed, MP could become a standard clinical tool.
authors.affiliation: Institute of Oncology, Davidoff Center, Rabin Medical Center, 39 Jabotinsky Street, 49100 Petah Tikva, Israel ; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978 Tel Aviv, Israel.
authors.forename: Aron
authors.initials: A
authors.lastname: Popovtzer
authors.affiliation: Institute of Oncology, Davidoff Center, Rabin Medical Center, 39 Jabotinsky Street, 49100 Petah Tikva, Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Sarfaty
authors.affiliation: Institute of Oncology, Davidoff Center, Rabin Medical Center, 39 Jabotinsky Street, 49100 Petah Tikva, Israel.
authors.forename: Dror
authors.initials: D
authors.lastname: Limon
authors.affiliation: Institute of Oncology, Davidoff Center, Rabin Medical Center, 39 Jabotinsky Street, 49100 Petah Tikva, Israel ; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978 Tel Aviv, Israel.
authors.forename: Gideon
authors.initials: G
authors.lastname: Marshack
authors.affiliation: Radiology Department, Rabin Medical Center, 39 Jabotinsky Street, 49100 Petah Tikva, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Perlow
authors.affiliation: Oncotest-Teva Pharmaceutical Industries, Ltd., Hatee'na 1, 60850 Shoham, Israel.
authors.forename: Addie
authors.initials: A
authors.lastname: Dvir
authors.affiliation: Oncotest-Teva Pharmaceutical Industries, Ltd., Hatee'na 1, 60850 Shoham, Israel.
authors.forename: Lior
authors.initials: L
authors.lastname: Soussan-Gutman
authors.affiliation: Institute of Oncology, Davidoff Center, Rabin Medical Center, 39 Jabotinsky Street, 49100 Petah Tikva, Israel ; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978 Tel Aviv, Israel.
authors.forename: Salomon M
authors.initials: SM
authors.lastname: Stemmer
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D005240:Feasibility Studies; D005260:Female; D020869:Gene Expression Profiling / Q000379:methods*; D049690:History, Ancient; D006801:Humans; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000379:methods*; D018802:Patient-Centered Care / Q000379:methods; D015203:Reproducibility of Results; D012468:Salivary Gland Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000556:secondary*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor