Characterization, treatment and outcomes of salivary ductal carcinoma using the National Cancer Database

Osborn, Virginia; Givi, Babak; Lee, Anna; Sheth, Niki; Roden, Dylan F.; Schwartz, David L.; Schreiber, David

doi:10.1016/j.oraloncology.2017.05.005

Cited by 61 publications

(84 citation statements)

References 24 publications

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“…A larger retrospective evaluation of 495 patients with SDC listed in the National Cancer Database indicated that surgical resection was superior to all other modalities, with insufficient data available to properly evaluate the role of conventional or targeted chemotherapies. 7 …”

Section: Discussionmentioning

confidence: 99%

First-Line Treatment of Widely Metastatic BRAF-Mutated Salivary Duct Carcinoma With Combined BRAF and MEK Inhibition

Lin¹,

Nabell²,

Spencer³

et al. 2018

J Natl Compr Canc Netw

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Salivary duct carcinoma (SDC) is a rare and aggressive malignancy for which limited data exist to guide treatment decisions. With the advent of advanced molecular testing and tumor genomic profiling, clinicians now have the ability to identify potential therapeutic targets in difficult-to-treat cancers such as SDC. This report presents a male patient with widely metastatic SDC found on targeted next-generation sequencing to have a BRAF p.V600E mutation. He experienced a prolonged and robust response to first-line systemic chemotherapy with dabrafenib and trametinib. During his response interval, new data emerged to justify subsequent treatment with both an immune checkpoint inhibitor and androgen blockade after his disease progressed. To our knowledge, this is the first report of frontline BRAF-directed therapy eliciting a response in metastatic SDC.

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Section: Discussionmentioning

confidence: 99%

First-Line Treatment of Widely Metastatic BRAF-Mutated Salivary Duct Carcinoma With Combined BRAF and MEK Inhibition

Lin¹,

Nabell²,

Spencer³

et al. 2018

J Natl Compr Canc Netw

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“…In the SEER database analysis, the authors found that increasing age, late stage, and N+ disease were associated with OS in multivariable analysis [19]. Similarly, a recent NCDB analysis showed that increasing age, male sex, and Stage IV disease were significant predictors of worse OS in a multivariable Cox regression model [38]. …”

Section: Outcomes: Survival and Prognostic Factorsmentioning

confidence: 99%

“…T3 or T4), with figures ranging from 35–74% [2, 4–7, 9, 11, 12, 14, 15, 18, 22, 31–38]. Two separate National Cancer Data Base (NCDB) studies, each with over 400 patients, found that 40–42% of patients presented with advanced T stage [36, 38]. However, analyses of multi-institutional data in Japan revealed an advanced T stage incidence of 65–66% [35, 37].…”

Section: Introductionmentioning

confidence: 99%

“…However, analyses using national databases or multiple institutions described an N+ incidence of 47–56% [2, 19, 35–38]. In a National Cancer Data Base (NCDB) analysis of 22,653 patients with parotid malignancies, the risk of N+ disease and occult nodal disease were 54% and 24%, respectively, for patients with SDC, higher than that seen for any other parotid gland pathologies (mean for all parotid malignancies: 24% and 10%, respectively) [36].…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, adjuvant radiation is performed in most series, which is reasonable given the aggressive clinical course of SDC. The role of systemic cytotoxic chemotherapy in the adjuvant setting is unclear, although it can be an option in patients with recurrent or distant metastatic disease [7, 38]. …”

Section: Introductionmentioning

confidence: 99%

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Salivary duct carcinoma: An aggressive salivary gland malignancy with opportunities for targeted therapy

2017

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Salivary duct carcinoma (SDC) is a rare, aggressive salivary malignancy that is often diagnosed at an advanced stage. Previously, little was known about outcomes of this disease due to its rarity. In the past several years, much has been learned about salivary duct carcinoma after publication of outcomes from several large single-institution series and national database searches. Recent studies of genomic alterations have helped elucidate the biology and pathogenesis of this aggressive disease. Here we review outcomes of the disease, effects of treatment, prognostic factors, and genomic alterations in SDC. Studies of targeted therapy and promising future directions are also discussed.

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A nomogram involving immune‐inflammation index for predicting distant metastasis‐free survival of major salivary gland carcinoma following postoperative radiotherapy

Yan

Shen

et al. 2022

Cancer Medicine

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Background Postoperative radiotherapy (PORT) is beneficial in the improvement of local‐regional control and overall survival (OS) for major salivary gland carcinomas (SGCs), and distant metastasis remained the main failure pattern. This study was designed to develop a nomogram model involving immune‐inflammation index to predict distant metastasis‐free survival (DMFS) of major SGCs. Patients and Methods A total of 418 patients with major SGCs following PORT were randomly divided into a training ( n = 334) and validation set ( n = 84). The pre‐radiotherapy neutrophil‐to‐lymphocyte ratio (NLR), and platelet‐to‐lymphocyte ratio (PLR) were calculated and transformed as continuous variables for every patient. Associations between DMFS and variables were performed by univariate and multivariable analysis using Log‐rank and Cox regression methods. A nomogram was constructed based on the prognostic factors identified by the Cox hazards model. The decision curve analysis (DCA) was conducted with the training and validation set. Results The estimated 3‐, 5‐, and 10‐year DMFS were 79.4%, 71.8%, and 59.1%, respectively. The multivariate analysis revealed that age ( p = 0.033), advanced T stage ( p = 0.003), positive N stage ( p < 0.001), high‐risk pathology ( p = 0.011), and high PLR ( p = 0.001) were significantly associated with worse DMFS. The nomogram showed good calibration and discrimination in the training (AUC = 80.9) and validation set (AUC = 87.9). Furthermore, the DCA demonstrated favorable applicability, and a significant difference ( p < 0.001) was observed for the DMFS between the subgroups based on the nomogram points. Conclusion The nomogram incorporating clinicopathological features and PLR presented accurate individual prediction for DMFS of the patients with major SGCs following PORT. Further external validation of the model is warranted for clinical utility.

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Characterization, treatment and outcomes of salivary ductal carcinoma using the National Cancer Database

Cited by 61 publications

References 24 publications

First-Line Treatment of Widely Metastatic BRAF-Mutated Salivary Duct Carcinoma With Combined BRAF and MEK Inhibition

First-Line Treatment of Widely Metastatic BRAF-Mutated Salivary Duct Carcinoma With Combined BRAF and MEK Inhibition

Salivary duct carcinoma: An aggressive salivary gland malignancy with opportunities for targeted therapy

A nomogram involving immune‐inflammation index for predicting distant metastasis‐free survival of major salivary gland carcinoma following postoperative radiotherapy

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