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Molecularly guided treatment of metastatic parotid gland carcinoma in adults
Hossein Taghizadeh1,2, Leonhard Müllauer3, Robert M Mader1
1Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
Background:
Advanced therapy-refractory parotid gland carcinomas have a poor prognosis with limited therapy options. We used molecular profiling to offer molecular guided therapies to patients with advanced metastatic parotid gland malignancies.
Methods:
In this retrospective analysis we describe the molecular profiling of ten patients diagnosed with therapy-refractory metastatic parotid gland malignancies.
Results:
We identified seven genetic aberrations in five patients: two mutations in CDKN2A and one mutation in APC, ATM, TP53, SMARCB1 and FGFR1, respectively. No mutations were detected in five patients. The IHC demonstrated frequent expressions of EGFR and p‑mTOR, as well as PTEN in eight patients. For four fifths (n = 8) of the patients, a targeted therapy was suggested. Eventually, three patients received the targeted therapy recommendation and one patient achieved stable disease for 14 months.
Conclusion:
A total of eight therapy recommendations were provided. Based on our observations, molecular-guided therapies may be a feasible treatment approach for this rare disease entity.
Insights
Molecular profiling identified genetic aberrations in advanced parotid gland carcinomas, guiding targeted therapies. One patient achieved stable disease, suggesting this approach is feasible for rare malignancies.
Area of Science:
- Oncology
- Genetics
- Molecular Biology
Background:
- Advanced therapy-refractory parotid gland carcinomas present a poor prognosis.
- Limited therapeutic options exist for these advanced metastatic malignancies.
- Molecular profiling offers a novel approach to guide therapy selection.
Purpose of the Study:
- To investigate the utility of molecular profiling in patients with advanced metastatic parotid gland carcinomas.
- To identify actionable genetic aberrations for targeted therapy in this patient cohort.
Main Methods:
- Retrospective analysis of molecular profiling data from ten patients with therapy-refractory metastatic parotid gland malignancies.
- Genetic aberration analysis and immunohistochemistry (IHC) for key proteins.
- Assessment of targeted therapy recommendations and outcomes.
Main Results:
- Seven genetic aberrations were identified in five patients, including mutations in CDKN2A, APC, ATM, TP53, SMARCB1, and FGFR1.
- Frequent expression of EGFR, p-mTOR, and PTEN was observed in most patients.
- Targeted therapy was suggested for eight patients, with three receiving recommendations and one achieving stable disease for 14 months.
Conclusions:
- Molecular profiling can identify actionable targets in advanced parotid gland carcinomas.
- Molecular-guided therapies represent a feasible treatment strategy for this rare cancer.
- Further research is warranted to validate these findings in larger cohorts.
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