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Approaches to the Management of Metastatic Adenoid Cystic Carcinoma.
Lee, Rex H; Wai, Katherine C; Chan, Jason W; Ha, Patrick K; Kang, Hyunseok.
Afiliação
  • Lee RH; Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA 94143, USA.
  • Wai KC; Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, CA 94304, USA.
  • Chan JW; Department of Radiation Oncology, University of California San Francisco, San Francisco, CA 94143, USA.
  • Ha PK; Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA 94143, USA.
  • Kang H; Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA.
Cancers (Basel) ; 14(22)2022 Nov 20.
Article em En | MEDLINE | ID: mdl-36428790
High rates of recurrence and distant metastasis are a foremost challenge in the management of adenoid cystic carcinoma (ACC), occurring in approximately 40% of all ACC patients. Despite the morbidity and mortality resulting from recurrent/metastatic (R/M) disease, there are no FDA-approved systemic agents for these patients. In this review, we summarize pertinent ACC pathophysiology and its implications for different systemic treatment regimens in R/M ACC. We review the evidence for the most widely used systemic agents - cytotoxic chemotherapy and tyrosine kinase inhibitors (TKIs) targeting VEGFR - in addition to immune checkpoint inhibitors and non-TKI biologic agents. Exciting emerging targets for R/M ACC, including inhibitors of Notch signaling, stemness, PRMT5, and Axl, are also discussed. Lastly, we review local therapies for small-volume lung disease in patients with oligometastatic ACC, specifically pulmonary metastasectomy and stereotactic body radiation therapy (SBRT). Future development of targeted molecular agents which exploit the underlying biology of this disease may yield novel therapeutic options to improve clinical outcomes in patients with R/M ACC.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Revista: Cancers (Basel) Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Base de dados: MEDLINE Idioma: En Revista: Cancers (Basel) Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos