title: Systemic therapy in metastatic salivary gland carcinomas: A pathology-driven paradigm?
abstract: Salivary gland carcinomas (SGCs) represent one of the most complex tumors from a pathological point of view. According to the World Health Organization (WHO) classification (2005), twenty-four malignant histotypes are recognized, almost all characterized by specific morphological and genetic features as well as by particular clinical behavior. Loco-regional relapse and distant metastases are quite common. Distant metastases are diagnosed in 25-55% of the patients and only 20% of them are alive after 5years. Adenoid cystic carcinoma (ACC) is the most common (60%) malignant histotype observed in patients with metastatic disease, whilst the other histotypes such as mucoepidermoid carcinoma, salivary duct carcinoma, adenocarcinoma, not otherwise specified (NOS), and myoepithelial carcinoma are rarer. The most common therapeutic approach in cases of metastatic disease is systemic chemotherapy, although the results with this type of approach are poor both in terms of response rate and overall outcome. No consensus has yet been reached on what the standard regimen of chemotherapy should be in this setting. New therapies are under investigation e.g. antiangiogenic agents, histone deacetylase inhibitors, and hormonal deprivation treatment. We have focused our review on systemic treatments in ACC and in non-ACC tumors, including in this latter group all SGC histotypes other than ACC.
authors.affiliation: Medical Oncology Unit 3, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; University of Milan, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Alfieri
authors.affiliation: Medical Oncology Unit 3, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; University of Milan, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Granata
authors.affiliation: Medical Oncology Unit 3, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; University of Milan, Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Bergamini
authors.affiliation: Medical Oncology Unit 3, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; University of Milan, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Resteghini
authors.affiliation: Medical Oncology Unit 3, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; University of Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bossi
authors.affiliation: Medical Oncology Unit 3, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; University of Milan, Italy.
authors.forename: Lisa F
authors.initials: LF
authors.lastname: Licitra
authors.affiliation: Medical Oncology Unit 3, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; University of Milan, Italy. Electronic address: laura.locati@istitutotumori.mi.it.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Locati
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006801:Humans; D009362:Neoplasm Metastasis; D012468:Salivary Gland Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents
keywords: ACC; Androgen deprivation therapy; Chemotherapy; Metastatic; Salivary gland carcinoma; Systemic; Targeted therapy