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Role of Androgen Receptor and EGFR in Carcinoma ex Pleomorphic Adenoma: A Systematic Review and Meta- Analysis
Ija Mayuek1, Abikshyeet Panda1, Harish Kumar1
1Department of Oral and Maxillofacial Pathology and Oral Microbiology, KIIT UNIVERSITY, Kalinga Institute of Dental Sciences (KIDS), Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar- 751024, Odisha, India.
Background:
Carcinoma ex pleomorphic adenoma (Ca-ex-PA) is a rare salivary gland malignancy with limited therapeutic options. Molecular targets such as androgen receptor (AR) and epidermal growth factor receptor (EGFR) may offer prognostic and therapeutic value.
Objective:
To systematically review the current literature regarding the role of AR and EGFR in the pathogenesis, progression, and management of Ca-ex-PA.
Methods:
The review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and was registered in PROSPERO with the registration number CRD420251118578. A systematic literature search was conducted in PubMed, Scopus, Google Scholar, and EBSCOhost databases for studies published upto January, 2026. Inclusion criteria were studies assessing AR and/or EGFR in Ca-ex-PA using immunohistochemistry, molecular techniques, or clinical data. Risk of bias was assessed using the ROBINS tool, and pooled prevalence estimates were calculated using random-effects models.
Results:
Eighteen studies were included for qualitative synthesis and meta-analysis. AR expression was found to be highly prevalent in CXPA, particularly in cases with salivary duct carcinoma components, while benign pleomorphic adenoma consistently showed minimal or absent AR expression. EGFR expression demonstrated marked heterogeneity across studies but was generally higher in malignant components compared with benign areas. Overall, included studies exhibited moderate to high risk of bias, mainly related to confounding, post-exposure interventions, and selective reporting.
Conclusion:
AR is a consistently expressed and biologically relevant biomarker in CXPA, supporting its diagnostic and potential therapeutic role. EGFR expression reflects molecular heterogeneity and may contribute to malignant progression, although its clinical utility remains uncertain. Standardized biomarker assessment and prospective studies are required to strengthen evidence and guide targeted therapy in CXPA.
