Antizyme inhibitor 2 (AZIN2) associates with better prognosis of head and neck minor salivary gland adenoid cystic carcinoma

6086 Background: For most patients with recurrent or metastatic salivary gland cancer (RM-SGC), there are no standard therapies. Many patients undergo genomic profiling to guide selection of targeted therapy. The MSK-IMPACT study applied a 468 gene next generation sequencing (NGS) panel, identifying actionable mutations in 34/114 patients (30%) with RM-SGC. Minimising cost will facilitate application within publically funded healthcare systems. We therefore sought to determine the utility of genomic profiling using a focused 24 gene targeted NGS panel to identify actionable mutations in RM-SGC with a sub-group analysis in adenoid cystic carcinoma (ACC) and non-ACC sub-types. Methods: From January 2017 to 2018, 125 patients with RM-SGC provided informed consent to an ethically approved study. Clinical and demographic characteristics were collected. DNA was extracted from FFPE samples and analysed using Qiagen GeneRead DNAseq Targeted Panel V2 in the Manchester Centre for Genomic Medicine Diagnostic Laboratory, an NHS clinically accredited lab. A custom bioinformatic pipeline was validated to detect single nucleotide variants and indels ( < 40bp) to 5% mutant allele frequency. Alterations were categorised following American College of Medical Genetics guidelines and Association for Molecular Pathology tiering. Results: DNA from 101 tumours (69 major, 32 minor salivary gland) was sequenced with 95% coverage at > 350x read depth over the target enrichment. 65 patients had adenoid cystic carcinoma (ACC) and 36 had non-ACC SGC. Median age was 55 years (range 18-80). 43 actionable alterations were identified in 33 patients within the following genes: TP53 (21%), PIK3CA (8%), ERBB2 (6%), PTEN (3%), BRAF (2%), EGFR (T790M) (1%), and AKT1 (1%). Targeted therapy was selected based on genomic findings in 12% of these patients. In ACC patients, actionable alterations were seen in 25% compared with 55% of non-ACC patients (9 adenocarcinoma, 5 salivary duct carcinoma, 3 carcinoma ex pleomorphic adenoma, 2 mucoepidermoid carcinoma and 1 myoepithelial carcinoma). Conclusions: This study identified actionable alterations in 33% of SGC patients using focused genomic profiling, demonstrating comparable utility to larger research panels. This focussed panel is being expanded to include emerging biomarkers such as NOTCH gene mutations, with NOTCH inhibitors currently in trials in ACC. Greater access to basket studies incorporating therapies matched to genomic alterations will maximise the clinical utility of this approach.

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Clinicopathological profile of adenoid cystic carcinoma of minor salivary gland tumour: our experience at a tertiary care centre

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203195 ◽

2020 ◽

Vol 6 (8) ◽

pp. 1460

Author(s):

Prakash Mylanahalli Doddrangaiah ◽

Bharath Kanna Karunakaran ◽

Roopa S. Mallali ◽

Afshan Fathima

Keyword(s):

Salivary Gland ◽

Adenoid Cystic Carcinoma ◽

Salivary Glands ◽

Hard Palate ◽

Minor Salivary Gland ◽

Salivary Gland Tumour ◽

Minor Salivary Glands ◽

Adenoid Cystic ◽

Minor Salivary Gland Tumour ◽

Gland Tumour

Background: Adenoid cystic carcinoma (ACC) is a rare malignant tumour originating from minor salivary glands. It is known for perineural spread, local recurrences and distant metastasis. The minor salivary gland tumour represents 3% of all head and neck neoplasms, whereas ACC constitutes about 0.5% of all malignant salivary gland neoplasms. This study was done to evaluate the clinical presentation and histopathological findings of minor salivary gland tumour.Methods: This study was done in the department of ENT, Bangalore Medical College and Research Institute from May 2017 to July 2019. Of the 25 patients with minor salivary gland tumour, 10 patients with ACC were considered for the present study. A detailed clinical and histopathological evaluation was done. Results were documented and tabulated in excel sheet. Results: We analysed data of 25 (16 female, 9 male) patients in the age group of 30-60 years, of which 10 patients had adenoid cystic carcinoma of minor salivary gland tumour. The most frequent site of tumour occurrence was noted in the hard palate (6 patients), followed by retromolar trigone (2 patients), floor of mouth (1 patient) and tongue (1 patient). The histopathological pattern noted most commonly in our study: cribriform pattern (6 cases), tubular (1 case) and solid (3 cases).Conclusions: ACC of minor salivary glands is rare. The otorhinolaryngologist should bear this clinical entity in mind when encountered with a painless swelling over the hard palate. This would lead to an early diagnosis and prompt management in such patients.

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Neoadjuvant Chemotherapy as a viable treatment option for locally Advanced Adenoid Cystic Carcinoma of salivary gland: A case report

10.21203/rs.3.rs-669192/v1 ◽

2021 ◽

Author(s):

Vinayak Kerbaji More ◽

Ashish Jakhetiya ◽

Arun Pandey ◽

Tarang Patel

Keyword(s):

Salivary Gland ◽

Neoadjuvant Chemotherapy ◽

Adenoid Cystic Carcinoma ◽

Postoperative Radiotherapy ◽

Locally Advanced ◽

Minor Salivary Gland ◽

Salivary Gland Neoplasm ◽

R0 Resection ◽

Adenoid Cystic ◽

Selected Subset

Abstract Adenoid cystic carcinoma (ACC) is a rare and aggressive variant of salivary gland neoplasm. Perineural invasion and resistance to present chemotherapeutic drugs makes treatment more challenging. Surgery remains the treatment of choice in resectable cases with postoperative radiotherapy in selected subset. In upfront technically unresectable cases neoadjuvant chemotherapy (NACT) can be used as an option to achieve R0 resection. Here we present a case of minor salivary gland ACC that was successfully down staged and underwent R0 resection after NACT.

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Minor Salivary Gland Adenoid Cystic Carcinoma

10.32388/zna2ke ◽

2020 ◽

Author(s):

Keyword(s):

Salivary Gland ◽

Adenoid Cystic Carcinoma ◽

Minor Salivary Gland ◽

Adenoid Cystic

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Matrix metalloproteinase-7, -8, -9, -15, and -25 in minor salivary gland adenoid cystic carcinoma

Pathology - Research and Practice ◽

10.1016/j.prp.2020.153293 ◽

2021 ◽

Vol 217 ◽

pp. 153293

Author(s):

Hanna Hämetoja ◽

Antti Mäkitie ◽

Leif Bäck ◽

Ilmo Leivo ◽

Caj Haglund ◽

...

Keyword(s):

Salivary Gland ◽

Matrix Metalloproteinase ◽

Adenoid Cystic Carcinoma ◽

Minor Salivary Gland ◽

Adenoid Cystic ◽

Matrix Metalloproteinase 7

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Management of salivary gland adenoid cystic carcinoma: institutional experience of a case series

Sao Paulo Medical Journal ◽

10.1590/s1516-31802006000100006 ◽

2006 ◽

Vol 124 (1) ◽

pp. 26-30 ◽

Cited By ~ 20

Author(s):

Alfio José Tincani ◽

André Del Negro ◽

Priscila Pereira Costa Araújo ◽

Hugo Kenzo Akashi ◽

Antonio Santos Martins ◽

...

Keyword(s):

Salivary Gland ◽

Adenoid Cystic Carcinoma ◽

Postoperative Radiotherapy ◽

Minor Salivary Gland ◽

Salivary Gland Tumor ◽

Clinical Staging ◽

Major Salivary Gland ◽

Gland Tumor ◽

Adenoid Cystic

CONTEXT AND OBJECTIVE: Salivary gland tumor management requires long-term follow-up because of tumor indolence and possible late recurrence and distant metastasis. Adenoid cystic carcinoma (ACC) accounts for 10-15% of such tumors. The aim here was to evaluate surgical and clinical management, staging and follow-up of ACC patients in one academic institution. DESIGN AND SETTING: Retrospective study at Head and Neck Service, Universidade Estadual de Campinas. METHODS: Data on 21 patients treated between 1993 and 2003 were reviewed. Management utilized clinical staging, histology and imaging. Major salivary gland tumor extent was routinely assessed by preoperative ultrasonography. Diagnosis, surgery type, margin type (negative/positive), postoperative radiotherapy and recurrence (presence/absence) were evaluated. RESULTS: There were eleven major salivary gland tumors (52.3%), seven submandibular and four parotid. Ten patients (47.7%) had minor salivary gland ACC (all in palate), while the submandibular was the most frequently affected major one. Diagnoses were mostly via fine-needle aspiration (FNA) and incision biopsy. Frozen sections were used for six patients. There was good ultrasound/FNA correlation. Sixteen (76%) had postoperative radiotherapy. One (4.7%) died from ACC and five now have recurrent disease: three (14.2%) locoregional and two (9.5%) distant metastases. CONCLUSION: Adenoid cystic carcinoma has locally aggressive behavior. In 21 cases, of ACC, the facial nerve was preserved in all except in the few with gross tumor involvement. Treatment was defined from physical examination, imaging, staging and histology.

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