复发或转移性腺样体腺癌系统性治疗：一项系统评价
Systemic treatments in recurrent or metastatic salivary gland cancer: a systematic review
DOI 原文链接
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影响因子:8.3
分区:医学1区 Top / 肿瘤学2区
发表日期:2024 Oct
作者:
D Prost, S Iseas, M Gatineau, J Adam, S Cavalieri, C Bergamini, L Licitra, É Raymond
DOI:
10.1016/j.esmoop.2024.103722
摘要
腺样体腺癌较为罕见，且因其组织学多样性和临床表现差异，给晚期或复发阶段的最佳系统性治疗选择带来挑战。本系统评价旨在评估四种类型腺样体腺癌的总生存期（OS）和系统治疗反应。通过PubMed和Google Scholar检索，筛选涉及初发晚期或复发病例接受系统治疗的研究。基于系统评价与Meta分析的优选报告项目（PRISMA）标准，选取具有明确、个体化治疗反应和结局数据的研究。在筛查的723篇研究中，有44篇符合纳入标准。共纳入426例复发/转移性腺样体腺癌病例，主要为腺样导管癌（SDC；n=219）和腺样囊性癌（ACC；n=167）。组织分子标志物与组织学高度相关，HER2过表达和雄激素受体核表达常见于SDC和未特指的腺癌病例中，而KIT过表达仅在ACC中观察到。治疗反应率与特定受体阻断相关，曲妥珠单抗联合化疗和比卡鲁胺为最有效（总反应率分别为80%和42.8%）。此外，治疗反应对总生存期具有积极影响（反应者中位生存期为38个月，非反应者为18.7个月；P<0.001）。在本次回顾性分析中，不同组织学类型的生存结果显示，抗人类表皮生长因子受体2（HER2）治疗对SDC更有效，而化疗对ACC效果更佳。系统性治疗有助于复发或新发晚期腺样体腺癌患者的生存，治疗反应受到组织学亚型和治疗靶点的显著影响。
Abstract
Salivary gland cancers are infrequent and pose a challenge owing to their histological diversity and varied clinical behavior, making the selection of optimal systemic treatments for advanced or recurrent stages difficult. This systematic review aims to assess overall survival outcomes and systemic treatment responses across four types of salivary cancers.A PubMed and Google Scholar search identified studies involving initially advanced or relapsed cases undergoing systemic treatment. Studies with clear, individualized data on treatment responses and outcomes were selected based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Of the 723 studies screened, 44 met our inclusion criteria.A total of 426 cases of recurrent/metastatic salivary gland cancer, mostly salivary duct carcinoma (SDC; n = 219) and adenoid cyst carcinoma (ACC; n = 167), were included. Histomolecular markers were heavily associated with histology, with HER2 overexpression and androgen receptor nuclear expression typically found in SDC and adenocarcinoma not otherwise specified cases and KIT overexpression only in ACC. The response rates were associated with specific receptor blockage, with trastuzumab plus chemotherapy, and bicalutamide being the most effective (overall response rate 80% and 42.8%, respectively). Moreover, the response to treatment positively influenced overall survival (responders 38 versus non-responders 18.7 median months; P < 0.001). In this retrospective analysis of a particular cohort, survival outcomes per histology types showed that anti-human epidermal growth factor receptor 2 therapy was more effective for SDC, while chemotherapy was more effective for ACC.Systemic treatments contribute to the survival of patients with salivary gland cancer at relapsed or newly advanced stages. The response to treatment is heavily influenced by histological subtype and treatment specificity.