Systemic Therapy in the Palliative Management of Advanced Salivary Gland Cancers

Cancers of the salivary glands are unusual lesions that vary widely in their histologic appearance and molecular characteristics. Likewise, there is a wide spectrum of biologic behavior, ranging from low-grade, minimally invasive tumors, to highly lethal malignancies. There are few data on the role of systemic therapies in the management of these cancers, and chemotherapy is generally reserved for the palliative management of advanced disease that is not amenable to local therapies such as surgery and/or radiation. The majority of patients for whom systemic therapy is considered will have either adenoid cystic carcinoma, mucoepidermoid carcinoma, or high-grade adenocarcinoma. This article will review the available literature regarding the use of palliative chemotherapy for patients with advanced salivary gland cancer of these histologies, with an emphasis on the potential role of targeted agents. There is a need for a determined, coordinated effort to conduct high-quality clinical trials in patients with these rare cancers.

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SP-0506: The role of systemic therapy in salivary gland cancer

Radiotherapy and Oncology ◽

10.1016/s0167-8140(21)00528-4 ◽

2020 ◽

Vol 152 ◽

pp. S279-S280

Author(s):

C. Van Herpen

Keyword(s):

Salivary Gland ◽

Systemic Therapy ◽

Salivary Gland Cancer

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The potential role of tea in periodontal therapy: An updated review

Current Drug Discovery Technologies ◽

10.2174/1389200221666200127114119 ◽

2020 ◽

Vol 17 ◽

Author(s):

Ali Forouzanfar ◽

Hamideh Sadat Mohammadipour ◽

Fatemeh Forouzanfar

Keyword(s):

Green Tea ◽

Potential Role ◽

Wide Spectrum ◽

Periodontal Diseases ◽

Herbal Remedies ◽

World Population ◽

Tea Leaves ◽

The World ◽

Green Tea Leaves

: Periodontal diseases are highly prevalent and can affect high percentage of the world population. Oxidative stress and inflammation plays an important role in the pathogenesis of periodontal diseases. Nowadays, more attention has been focused on the herbal remedies in the field of drug discovery. Green tea is an important source of polyphenol antioxidants, it has long been used as a beverage worldwide. The most interesting polyphenol components of green tea leaves that are related with health benefits are the catechins. Taken together this review suggested that green tea with its wide spectrum of activities could be a healthy alternative for controlling the damaging reactions seen in periodontal diseases.

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Systemic Therapy for Salivary Gland Cancer

Salivary Gland Pathology ◽

10.1002/9781119730248.ch14 ◽

2021 ◽

pp. 455-469

Author(s):

Janakiraman Subramanian ◽

Lara Kujtan

Keyword(s):

Salivary Gland ◽

Systemic Therapy ◽

Salivary Gland Cancer

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Exposure to emissions from Mount Etna (Sicily, Italy) and incidence of thyroid cancer: a geographic analysis

Scientific Reports ◽

10.1038/s41598-020-77027-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Paolo Boffetta ◽

Lorenzo Memeo ◽

Dario Giuffrida ◽

Margherita Ferrante ◽

Salvatore Sciacca

Keyword(s):

Regression Analysis ◽

Thyroid Cancer ◽

Potential Role ◽

Incidence Rates ◽

Mount Etna ◽

Sensitivity Analyses ◽

Molecular Characteristics ◽

Special Focus ◽

Northeastern Sicily

AbstractAn increased incidence of thyroid cancer has been reported in the area close to Mount Etna, the largest volcano in Europe located in Northeastern Sicily. We tested the hypothesis that exposure to the emissions from the volcano is associated with thyroid cancer in 186 municipalities from three provinces surrounding the volcano (1.9 million inhabitants). We measured the angle between the bearing of the municipalities and each direction, with special focus on South-East, the prevalent direction of the plume, and conducted a regression analysis on 2003–2016 incidence rates of thyroid cancer, adjusting for distance from Mount Etna, population size, and income. A 10-degree increase in the angle with South-East was associated with a decrease in thyroid cancer rates in the whole population (− 0.67 cases/100,000, p = 0.002) and in women (− 1.54/100,000, p < 0.001), and were robust to several sensitivity analyses. Similar results were obtained for East-South-East direction. These results support the hypothesis of a potential role of exposure to the plume from Mount Etna in determining the high rates of thyroid cancer. The results need to be confirmed in analytical studies, in which information of exposure to chemicals originating from the volcano, as well as other possible causes, should be carefully measured, molecular characteristics of the tumors and taken into account.

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The role of clinical and molecular characteristics in low grade gliomas

Annals of Oncology ◽

10.1093/annonc/mdx431.002 ◽

2017 ◽

Vol 28 ◽

pp. vi75-vi76

Author(s):

A. Mura ◽

E. Franceschi ◽

S. Minichillo ◽

A. Tosoni ◽

A. Fioravanti ◽

...

Keyword(s):

Molecular Characteristics ◽

Low Grade ◽

Low Grade Gliomas

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Results of photon radiotherapy for unresectable salivary gland tumors: is neutron radiotherapy’s local control superior?

Radiology and Oncology ◽

10.2478/raon-2013-0046 ◽

2014 ◽

Vol 48 (1) ◽

pp. 56-61 ◽

Cited By ~ 16

Author(s):

Daniel E. Spratt ◽

Lucas Resende Salgado ◽

Nadeem Riaz ◽

Michael G. Doran ◽

Moses Tam ◽

...

Keyword(s):

Salivary Gland ◽

Local Control ◽

Late Complications ◽

Salivary Gland Tumors ◽

Salivary Gland Cancer ◽

Low Grade ◽

Severe Toxicity ◽

Grade 3 ◽

Photon Radiotherapy

Abstract Background. The results of RTOG-MRC randomized trial of photon (n=15) versus neutron (n=17) therapy in the 1980’s reported an improved local control (LC) with neutron radiotherapy for unresectable salivary gland tumors. Due to increased severe toxicity with neutron radiotherapy and the paucity of neutron-therapy centers, we analyzed our institution’s results of photon radiotherapy for unresectable salivary gland tumors. Patients and methods. From 1990 to 2009, 27 patients with unresectable salivary gland cancer underwent definitive photon radiotherapy at our institution. Nodal involvement on presentation was found in 9 patients. Median dose of radiotherapy was 70 Gy. Chemotherapy was given to 18 patients, most being platinum-based regimens. Local control (LC), locoregional control (LRC), distant metastasis-free survival (DMFS), overall survival (OS), and toxicity outcomes were assessed. Results. With a median follow-up of 52.4 months, the 2/5-year actuarial LC was 69% (95%CI ± 21.0%)/55% (± 24.2%), LRC was 65% (± 21.4%)/47% (± 21.6%), and DMFS was 71% (± 21.8%)/51% (± 22.8%), respectively using competing risk analysis. The median OS was 25.7 months, and the 2/5-year OS rates were 50% (± 19.0%)/29% (± 16.6%), respectively. Higher histologic grade was significant for an increased rate of DM (intermediate grade vs. low grade, p=0.04, HR 7.93; high grade vs. low grade, p=0.01, HR 13.50). Thirteen (48%) patient’s experienced acute grade 3 toxicity. Late grade 3 toxicity occurred in three (11%) patients. Conclusions. Our data compares favorably to neutron radiotherapy with fewer late complications. Photon radiotherapy is an acceptable alternative to neutron radiotherapy in patients who present with unresectable salivary gland tumors.

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The contemporary role of metastasectomy in the management of metastatic RCC

10.20517/2394-4722.2021.164 ◽

2021 ◽

Author(s):

Zachary Feuer ◽

Jacob I. Taylor ◽

William C. Huang

Keyword(s):

Systemic Therapy ◽

Therapeutic Strategy ◽

Small Volume ◽

Therapeutic Option ◽

Contemporary Literature ◽

Randomized Controlled ◽

Patient Selection Bias ◽

Systemic Therapies ◽

Single Organ

Metastasectomy was initially described in the 1970s as a therapeutic strategy for patients with metastatic renal cell carcinoma. Since that time, systemic therapy options have grown exponentially, most recently with the introduction of immunotherapy. We aimed to review the contemporary literature regarding the role of metastasectomy in the era of targeted therapy and immunotherapy. Historically, metastasectomy has benefited patients with small volume, single-organ metastases, with favorable outcomes amongst younger, healthier patients with metastases to specific sites. The interplay between the employment of metastasectomy and systemic therapy has been limited to small, retrospective series with significant patient selection bias. More recently, investigators have conducted randomized controlled trials exploring the use of targeted therapies in the adjuvant setting after metastasectomy. Initial randomized data suggested no benefit in using sorafenib in this setting, and a subsequent study demonstrated possible harm in using pazopanib after metastasectomy. However, the role of other novel systemic therapies, including immunotherapy, nor the timing of use, have been meaningfully explored. Metastasectomy appears to be a valuable therapeutic option in the properly selected patient, requiring a multi-disciplinary management strategy and, pending future trials, a multimodal treatment approach.

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The Presence and Potential Role of ALDH1A2 in the Glioblastoma Microenvironment

Cells ◽

10.3390/cells10092485 ◽

2021 ◽

Vol 10 (9) ◽

pp. 2485

Author(s):

Stephanie Sanders ◽

Denise M. Herpai ◽

Analiz Rodriguez ◽

Yue Huang ◽

Jeff Chou ◽

...

Keyword(s):

Tumor Cells ◽

Potential Role ◽

Therapeutic Agents ◽

Brain Parenchyma ◽

Low Grade ◽

Effective Management ◽

Diffuse Infiltration ◽

Protein Levels ◽

The Brain

Glioblastoma (GBM) is the most aggressive malignant glioma. Therapeutic targeting of GBM is made more difficult due to its heterogeneity, resistance to treatment, and diffuse infiltration into the brain parenchyma. Better understanding of the tumor microenvironment should aid in finding more effective management of GBM. GBM-associated macrophages (GAM) comprise up to 30% of the GBM microenvironment. Therefore, exploration of GAM activity/function and their specific markers are important for developing new therapeutic agents. In this study, we identified and evaluated the expression of ALDH1A2 in the GBM microenvironment, and especially in M2 GAM, though it is also expressed in reactive astrocytes and multinucleated tumor cells. We demonstrated that M2 GAM highly express ALDH1A2 when compared to other ALDH1 family proteins. Additionally, GBM samples showed higher expression of ALDH1A2 when compared to low-grade gliomas (LGG), and this expression was increased upon tumor recurrence both at the gene and protein levels. We demonstrated that the enzymatic product of ALDH1A2, retinoic acid (RA), modulated the expression and activity of MMP-2 and MMP-9 in macrophages, but not in GBM tumor cells. Thus, the expression of ALDH1A2 may promote the progressive phenotype of GBM.

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