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Sinonasal undifferentiated carcinoma (SNUC): morphoproteomic-guided treatment paradigm with clinical efficacy
Maria Ansari1, Shan Guo, Samer Fakhri
1Division of Oncology, Department of Internal Medicine, University of Texas Medical School at Houston and Memorial Hermann Cancer Center, Houston, TX 77030, USA.
Abstract:
Sinonasal undifferentiated carcinoma (SNUC) is a rare and highly malignant tumor that occurs in the nasal cavity and/or paranasal sinuses. Prognosis is poor despite multimodality treatment. Currently, there is no optimal standard of treatment, partially due to a lack of research defining the biology of such tumors. This report discusses two SNUC cases where patients received a novel chemotherapeutic approach using cisplatin, etoposide, Adriamycin (doxorubicin), metformin, and adjuvant melatonin therapies based on morphoproteomic-guidance, followed by consolidation with chemoradiation therapy. This resulted in excellent and objective tomographic and magnetic resonance imaging and clinical responses including complete responses in the induction phase utilizing morphoproteomic-guided therapies. Later, endoscopic excision of the tumor bed failed to reveal any residual tumor. Morphoproteomics helped to define the biology of these SNUC tumors and provided targets for the agents employed, creating a new treatment paradigm for such tumors. This treatment regimen poses a new effective regimen to treat SNUC.
Insights
A novel morphoproteomic-guided therapy combining chemotherapy and adjuvant agents shows promise for treating sinonasal undifferentiated carcinoma (SNUC), a rare and aggressive cancer. This approach led to complete tumor responses in two patients, offering a new treatment paradigm.
Area of Science:
- Oncology
- Translational Medicine
Background:
- Sinonasal undifferentiated carcinoma (SNUC) is a rare, aggressive malignancy with a poor prognosis and no established standard treatment.
- Understanding SNUC tumor biology is crucial for developing effective therapeutic strategies.
Observation:
- Two SNUC cases were treated with a novel regimen: cisplatin, etoposide, doxorubicin, metformin, and melatonin, guided by morphoproteomics.
- This induction therapy was followed by consolidation chemoradiation.
Findings:
- Morphoproteomic guidance identified therapeutic targets, leading to excellent objective responses on imaging and clinical evaluation.
- Complete responses were observed during the induction phase, with no residual tumor found upon endoscopic excision.
Implications:
- Morphoproteomics can define SNUC tumor biology and guide targeted therapy selection.
- This novel, morphoproteomic-guided regimen represents a promising new treatment paradigm for SNUC, potentially improving patient outcomes.