Clinical and molecular insights into adenoid cystic carcinoma: Neural crest-like stemness as a target

Area of Science:

• Oncology
• Cancer Stem Cell Biology
• Molecular Pathology

Background:

• Adenoid cystic carcinoma (ACC) is a rare, slow-growing salivary gland malignancy characterized by nerve invasion and metastasis.
• Current treatments for ACC are limited to surgery and radiation, with no curative options for metastatic disease.
• Lack of understanding of molecular drivers and validated markers has historically hindered ACC research and therapeutic development.

Purpose of the Study:

• To review current therapies and molecular defects in ACC.
• To emphasize the role of neural crest-like stemness in ACC, focusing on cancer stem cells (CSCs).
• To identify potential therapeutic strategies targeting ACC CSCs.

Main Methods:

• Systematic review of articles on ACC and neural crest-like stem cells.
• Inclusion of data from Pubmed, OVID MEDLINE databases, and unpublished data.
• Analysis of recent advancements in ACC research tools and models, including cell culture and patient-derived xenografts.

Main Results:

• Preclinical research has yielded limited effective targets for ACC, evidenced by numerous failed clinical trials.
• Emerging molecular data indicate that neural crest-like stemness drivers are crucial for ACC maintenance.
• Cancer stem cells (CSCs) are identified as a significant therapeutic target in ACC.

Conclusions:

• Neural crest-like stemness represents a key therapeutic target in adenoid cystic carcinoma.
• Targeting cancer stem cells (CSCs) holds promise for developing novel and effective treatments for ACC.
• Advancements in research models and molecular understanding are crucial for future ACC therapeutic strategies.