François Cherifi1, Audrey Rambeau2, Alison Johnson2, Carmen Florescu3, Bernard Géry3, Emmanuel Babin4, Juliette Thariat5. 1. Centre François-Baclesse, ARCHADE, department of radiation oncology, 3, avenue General Harris, 14000 Caen, France; Centre François-Baclesse, ARCHADE, department of medical oncology, 3, avenue General Harris, 14000 Caen, France. 2. Centre François-Baclesse, ARCHADE, department of medical oncology, 3, avenue General Harris, 14000 Caen, France. 3. Centre François-Baclesse, ARCHADE, department of radiation oncology, 3, avenue General Harris, 14000 Caen, France. 4. Centre hospitalier universitaire Caen Normandie, department of head and neck surgery, avenue de la Côte de Nacre, 14000 Caen, France. 5. Centre François-Baclesse, ARCHADE, department of radiation oncology, 3, avenue General Harris, 14000 Caen, France; Laboratoire de physique corpusculaire IN2P3/ENSICAEN - UMR6534, boulevard du Marechal Juin, 14050 Caen, France; Normandie Université, Unicaen. Electronic address: jthariat@gmail.com.
Abstract
INTRODUCTION: Adenoid Cystic Carcinoma is a rare tumor of the head and neck sphere. The purpose of this review is a state of the art of systemic treatments (chemotherapies, targeted therapies, immunotherapies) for locally recurrent or metastatic disease. MATERIAL AND METHODS: Our inclusion criteria included head and neck adult patient, metastatic or locally advanced, treated by a systemic therapy, and with at least 10 or more patients. RESULTS: Forty articles have been selected in this review. The objective response rate under chemotherapy was predominantly<10% (0-70%) with objective responses in monotherapy with cisplatin, mitoxantrone, vinorelbine and eribuline, and with cisplatin-vinorelbine combination. EGFR inhibitors provided 40% objective responses only in combination. Inhibitors of VEGF and histone deacetylase have allowed disease stabilization in progressive patients, with about 10% of objective response. Inhibitors of c-KIT monotherapy yield objective response rates of<5%. Direct inhibitors of the PI3K/AKT/mTOR pathway display 0% objective response rate. CONCLUSION: The best objective response rates were obtained with cisplatin-vinorelbine combination. Many targetable molecular abnormalities have been identified and studies have shown prolonged stabilization with EGFR, VEGF and HDAC inhibitors. Multi-disciplinary collaborative consultation (MCC) meetings such as French network of experts in rare head and neck tumors (REFCOR) or Molecular MCC should be proposed and may allow referral to centers proposing specific therapeutic trials.
INTRODUCTION:Adenoid Cystic Carcinoma is a rare tumor of the head and neck sphere. The purpose of this review is a state of the art of systemic treatments (chemotherapies, targeted therapies, immunotherapies) for locally recurrent or metastatic disease. MATERIAL AND METHODS: Our inclusion criteria included head and neck adult patient, metastatic or locally advanced, treated by a systemic therapy, and with at least 10 or more patients. RESULTS: Forty articles have been selected in this review. The objective response rate under chemotherapy was predominantly<10% (0-70%) with objective responses in monotherapy with cisplatin, mitoxantrone, vinorelbine and eribuline, and with cisplatin-vinorelbine combination. EGFR inhibitors provided 40% objective responses only in combination. Inhibitors of VEGF and histone deacetylase have allowed disease stabilization in progressive patients, with about 10% of objective response. Inhibitors of c-KIT monotherapy yield objective response rates of<5%. Direct inhibitors of the PI3K/AKT/mTOR pathway display 0% objective response rate. CONCLUSION: The best objective response rates were obtained with cisplatin-vinorelbine combination. Many targetable molecular abnormalities have been identified and studies have shown prolonged stabilization with EGFR, VEGF and HDAC inhibitors. Multi-disciplinary collaborative consultation (MCC) meetings such as French network of experts in rare head and neck tumors (REFCOR) or Molecular MCC should be proposed and may allow referral to centers proposing specific therapeutic trials.
Authors: Sarah Atallah; Morgane Marc; Antoine Schernberg; Florence Huguet; Isabelle Wagner; Antti Mäkitie; Bertrand Baujat Journal: Cancer Manag Res Date: 2022-06-04 Impact factor: 3.602