Cancer Research and Treatment

Original Articles

Locoregional Recurrence in Adenoid Cystic Carcinoma of the Breast: A Retrospective, Multicenter Study (KROG 22-14): Sang Min Lee, Bum-Sup Jang, Won Park, Yong Bae Kim, Jin Ho Song, Jin Hee Kim, Tae Hyun Kim, In Ah Kim, Jong Hoon Lee, Sung-Ja Ahn, Kyubo Kim, Ah Ram Chang, Jeanny Kwon, Hae Jin Park, Kyung Hwan Shin; Received February 23, 2024 Accepted July 11, 2024 Published online July 12, 2024; DOI: https://doi.org/10.4143/crt.2024.201 [Epub ahead of print]

Abstract PDF PubReader ePub: Purpose
This study aims to evaluate the treatment approaches and locoregional patterns for adenoid cystic carcinoma (ACC) in the breast, which is an uncommon malignant tumor with limited clinical data.
Materials and Methods
A total of 93 patients diagnosed with primary ACC in the breast between 1992 and 2022 were collected from multi-institutions. All patients underwent surgical resection, including breast-conserving surgery (BCS) or total mastectomy (TM). Recurrence patterns and locoregional recurrence-free survival (LRFS) were assessed.
Results
Seventy-five patients (80.7%) underwent BCS, and 71 of them (94.7%) received post-operative radiation therapy (PORT). Eighteen patients (19.3%) underwent TM, with five of them (27.8%) also receiving PORT. With a median follow-up of 50 months, the LRFS rate was 84.2% at 5 years. Local recurrence (LR) was observed in five patients (5.4%) and four cases (80%) of the LR occurred in the tumor bed. Three of LR (3/75, 4.0%) had a history of BCS and PORT, meanwhile, two of LR (2/18, 11.1%) had a history of mastectomy. Regional recurrence occurred in two patients (2.2%), and both cases had a history of PORT with (n=1) and without (n=1) irradiation of the regional lymph nodes. Partial breast irradiation (p=0.35), BCS (p=0.96) and PORT in BCS group (p=0.33) had no significant association with LRFS.
Conclusion
BCS followed by PORT was the predominant treatment approach for ACC of the breast and LR mostly occurred in the tumor bed. The findings of this study suggest that partial breast irradiation might be considered for PORT in primary breast ACC.

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Head and Neck cancer

Analysis of Response and Progression Patterns of Tyrosine Kinase Inhibitors in Recurrent or Metastatic Adenoid Cystic Carcinoma: A Post Hoc Analysis of Two KCSG Phase II Trials: Youjin Kim, Bhumsuk Keam, Eun Joo Kang, Jin-Soo Kim, Hye Ryun Kim, Keun-Wook Lee, Jung Hye Kwon, Kyoung Eun Lee, Yaewon Yang, Yoon Hee Choi, Min Kyoung Kim, Jun Ho Ji, Tak Yun, Moon Young Choi, Ki Hyeong Lee, Sung-Bae Kim, Myung-Ju Ahn; Cancer Res Treat. 2024;56(4):1068-1076. Published online April 15, 2024; DOI: https://doi.org/10.4143/crt.2024.008

Abstract PDF Supplementary Material PubReader ePub: Purpose
In this study, we evaluated 66 patients diagnosed with adenoid cystic carcinoma (ACC) enrolled in two Korean Cancer Study Group trials to investigate the response and progression patterns in recurrent and/or metastatic ACC treated with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs).
Materials and Methods
We evaluated 66 patients diagnosed with ACC who were enrolled in the Korean Cancer Study Group trials. The tumor measurements, clinical data, treatment outcomes, and progression patterns of therapy were analyzed.
Results
In the 66 patients (53 receiving axitinib and 13 receiving nintedanib), the disease control rate was 61%, and three patients achieved partial response. The median follow-up, median progression-free survival (PFS), overall survival, and 6-month PFS rate were 27.6%, 12.4%, and 18.1% months and 62.1%, respectively. Among 42 patients who experienced progression, 27 (64.3%) showed target lesion progression. Bone metastasis was an independent poor prognostic factor.
Conclusion
Overall, most patients demonstrated stable disease with prolonged PFS; however, prominent target lesion progression occurred in some patients. Thus, PFS may capture VEGFR-TKI efficacy better than the objective response rate.

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A Single-Arm, Prospective, Phase II Study of Cisplatin Plus Weekly Docetaxel as First-Line Therapy in Patients with Metastatic or Recurrent Salivary Gland Cancer: Hye Ryeon Kim, Su Jin Lee, Sehhoon Park, Hyun Ae Jung, Se-Hoon Lee, Han-Sin Jeong, Man Ki Chung, Myung-Ju Ahn; Cancer Res Treat. 2022;54(3):719-727. Published online November 1, 2021; DOI: https://doi.org/10.4143/crt.2021.1019

Abstract PDF PubReader ePub

Purpose
Salivary gland cancers (SGCs) are relatively rare but comprise various histologic subtypes, which complicates design of prospective trials. Systemic chemotherapy plays a limited role in treatment of SGCs, but cisplatin and docetaxel showed efficacy in a previous preclinical study. Here, we conduct a prospective, phase II study to evaluate the efficacy and toxicities of cisplatin plus weekly docetaxel in patients with metastatic or recurrent SGC.
Materials and Methods
We included patients with histologically confirmed SGCs of the following subtypes: mucoepidermoid carcinoma, adenocarcinoma, ductal carcinoma, or adenoid cystic carcinoma. Patients had no prior systemic chemotherapy for metastatic or recurrent tumors and at least one measurable lesion. Patients were treated with docetaxel 35 mg/m2 (D1, 8) and cisplatin 70 mg/m2 (D1) every 21 days.
Results
Forty-one patients were enrolled between April 2014 and October 2020. The median age was 58 years (range, 32 to 73 years). The most common histologic subtype was adenoid cystic carcinoma (63.4%), followed by ductal carcinoma (24.4%). The most common metastatic site was the lung (75.6%). The median treatment cycle was 5.5 (range, 3 to 8), and the objective response rate was 46.3%, with three complete responses. The median duration of response was 6.8 months (interquartile range, 4.0 to 10.2). The progression-free survival and overall survival were 9.4 months (95% confidence interval [CI], 8.4 to 10.5) and 28.2 months (95% CI, 22.7 to 33.6), respectively. There were no treatment-related deaths. The most common grade 3/4 adverse events were neutropenia (4.9%) and fatigue (4.9%).
Conclusion
Cisplatin plus weekly docetaxel is effective and tolerable with manageable toxicity as first-line therapy in patients with metastatic or recurrent SGC.

Citations

Citations to this article as recorded by

Systemic and Targeted Therapies in Adenoid Cystic Carcinoma
Alec J. Kacew, Glenn J. Hanna
Current Treatment Options in Oncology.2023; 24(1): 45. CrossRef
Major and minor salivary gland cancers: A multicenter retrospective study
Muhammet Bekir Hacioglu, Bulent Erdogan, Murat Bardakcı, Efnan Algın, Burcu Gulbagcı, Ilhan Hacibekiroglu, Jamshid Hamdard, Omer Fatih Olmez, Hadi Akkus, Berna Oksuzoglu, Sema Sezgin Goksu, Shute Ailia Dae, Ahmet Taner Sumbul, Muzaffer Ugraklı, Mustafa Ka
Head & Neck.2023; 45(7): 1643. CrossRef
Prognostic Significance of Primary Tumor Surgery in Adenoid Cystic Carcinoma Patients With Distant Metastases at Diagnosis: A Population-Based Database Analysis in Head and Neck Region
Han Li, Li Zhao, Yixuan Song, Yang Liu, Song Ni, Shaoyan Liu
Ear, Nose & Throat Journal.2023;[Epub] CrossRef
The Therapeutic Landscape of Salivary Gland Malignancies—Where Are We Now?
Robbert Cleymaet, Tijl Vermassen, Renaat Coopman, Hubert Vermeersch, Stijn De Keukeleire, Sylvie Rottey
International Journal of Molecular Sciences.2022; 23(23): 14891. CrossRef

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The Prognostic Significance of Notch1 and Fatty Acid Binding Protein 7 (FABP7) Expression in Resected Tracheobronchial Adenoid Cystic Carcinoma: A Multicenter Retrospective Study: Mian Xie, Xiaojun Wu, Jinjun Zhang, Chaosheng He, Shenhai Wei, Junyao Huang, Xinge Fu, Yingying Gu; Cancer Res Treat. 2018;50(4):1064-1073. Published online November 15, 2017; DOI: https://doi.org/10.4143/crt.2017.337

Abstract PDF Supplementary Material PubReader ePub

Purpose
Adenoid cystic carcinoma (ACC) of the trachea and bronchus is a rare tumor. Although MYB-NFIB oncogene fusion and Notch1 mutation have been identified in ACC, little is known about the expression and clinical significance of Notch1 and its target gene fatty acid binding protein 7 (FABP7) in tracheobronchial ACC.
Materials and Methods
Primary tracheobronchial ACC that were resected between 1998 and 2014 were identified through the pathology and oncology database from five thoracic oncology centers in China. A tissue array was constructed from the patients’ samples and the expressions of Notch1 and FABP7 were evaluated by immunohistochemistry. The association between the expression of both markers and survival was determined.
Results
Overexpression of Notch1 and FABP7, detected in 37.8% and 38.3% of 368 patients with tracheobronchial ACC, respectively, was an independent prognostic indicator for recurrencefree survival (RFS) by multivariable Cox proportional hazard model (p=0.032 and p=0.048, respectively). Overexpression of Notch1, but not of FABP7, predicted overall survival (OS) (p=0.018). When categorized into four groups according to coexpression of Notch1 and FABP7, patients with overexpression of both Notch1 and FABP7 belonged to the group with the shortest RFS and OS (p=0.01 and p=0.048, respectively).
Conclusion
Expression of Notch1 and FABP7, and coexpression of Notch1 and FABP7, is strongly associated with poor survival in resected tracheobronchial ACC. These data are consistent with the hypothesis that poor differentiation of tracheobronchial ACC correlates with the activation of Notch signaling.

Citations

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Clinical Utility of Fine-Needle Aspiration Cytology for Adenoid Cystic Carcinoma of the Trachea with Thyroid Invasion: A Case Report
Tomoo Jikuzono, Shigekazu Suzuki, Osamu Ishibashi, Shoko Kure, Atsuko Sakanushi, Munenaga Nakamizo, Masashi Kawamoto, Ryuji Ohashi, Tetsu Yamada, Iwao Sugitani
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Clinically Integrated Molecular Diagnostics in Adenoid Cystic Carcinoma
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Case Reports

Adenoid Cystic Carcinoma of the Breast: A Case Series of Six Patients and Literature Review: Miso Kim, Dae-Won Lee, Jin Im, Koung Jin Suh, Bhumsuk Keam, Hyeong-Gon Moon, Seock-Ah Im, Wonshik Han, In Ae Park, Dong-Young Noh; Cancer Res Treat. 2014;46(1):93-97. Published online January 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.1.93

Abstract PDF PubReader ePub

Adenoid cystic carcinoma (ACC) of the breast is a very rare and indolent tumor with a favorable prognosis, despite its triple-negative status. Due to its rarity, there has been no consensus regarding treatments, and treatment guidelines have not been established. Here, we report on six patients with ACC of the breast. All of the patients initially presented with localized disease and no axillary lymph node metastases. Although some of our patients developed local recurrence or distant metastases, all patients had a favorable clinical course, and to date, none of the patients has died from complications of her disease. Here, we described the clinicopathologic features of ACC of the breast and review the current literature.

Citations

Citations to this article as recorded by

MYB expression by immunohistochemistry is highly specific and sensitive for detection of solid variant of adenoid cystic carcinoma of the breast among all triple‐negative breast cancers
Harsh Batra, Priya S C Bose, Yang Ding, Alan Dai, Hui Chen, Constance T Albarracin, Hongxia Sun, Aysegul A Sahin, Fei Yang, Ignacio I Wistuba, Maria G Raso
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Adenoid Cystic Carcinoma of the Breast: Multimodality Imaging Findings and Review of the Literature
Nilgun Guldogan, Gul Esen, Yasemin Kayadibi, Fusun Taskin, Aysenur Oktay Alfatli, Fatma Nur Soylu Boy, Pinar Balci, Onur Bugdayci, Fatma Tokat, Tulin Ozturk, Mehtap Tunaci, Akif Enes Arikan
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Optimal surgical procedure for treating early-stage adenoid cystic carcinoma of the breast
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Locally Advanced Adenoid Cystic Carcinoma of the Breast—A Case Report with a Review of the Literature
Joanna Rypel, Paulina Kubacka, Joanna Mykała-Cieśla, Jacek Pająk, Weronika Bulska-Będkowska, Jerzy Chudek
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Adenoid Cystic Carcinoma of the Breast and Intraoperative Electron Radiotherapy: Single Case Report and Review of Literature
Giuseppe Accardo, Alba ML Capobianco, Giuseppe La Torre, Alexios Thodas, Graziella Marino, Leuconoe Grazia Sisti, Giulia Vita
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Palliative Radiotherapy in a Patient with Pulmonary Adenoid Cystic Carcinoma: BoKyong Kim; Cancer Res Treat. 2007;39(4):185-188. Published online December 31, 2007; DOI: https://doi.org/10.4143/crt.2007.39.4.185

Abstract PDF PubReader ePub

Primary adenoid cystic carcinoma in the lung is very rare, so its clinicopathologic characteristics have usually been extrapolated from the salivary disease. However, the clinical courses of pulmonary adenoid cystic carcinomas may be different from those of salivary disease, and individual differences may also exist. I report here on a case of a patient who was initially diagnosed as pulmonary adenoid cystic carcinoma with liver metastases and the tumor showed extreme radiosensitivity, but it also underwent an aggressive clinical course. Adenoid cystic carcinoma is usually known to be a slowly growing tumor, but it may rapidly disseminate, like in this patient. Therefore, the factors predicting aggressive behavior should be determined and the treatment might be individualized according to the primary sites and on the patient's basis.

Citations

Citations to this article as recorded by

A Case of Undetermined Adenoid Cystic Carcinoma With Airway Stenosis Treated With Palliative X-Ray Radiotherapy Leading to Significant Improvement in Patient’s General Condition
Nobuko Utsumi, Masafumi Inoue, Kosei Miura
Cureus.2023;[Epub] CrossRef
Stereotactic body radiotherapy for adenoid cystic carcinoma metastatic to the lung: a case report
Daijiro Kobayashi, Takanori Abe, Jun-ichi Saitoh, Takahiro Oike, Hiro Sato, Atsushi Musha, Tatsuji Mizukami, Tsuneo Shimizu, Takashi Nakano, Tatsuya Ohno
Journal of Medical Case Reports.2021;[Epub] CrossRef
Apigenin inhibits the proliferation of adenoid cystic carcinoma via suppression of glucose transporter-1
JIN FANG, YANG-YANG BAO, SHUI-HONG ZHOU, JUN FAN
Molecular Medicine Reports.2015; 12(5): 6461. CrossRef

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Original Article

p27Kipl, K-67 and Bcl-2 Expression in Adenoid Cystic Carcinoma of Head and Neck: C S Choi, G Choi, J J Song, K S Hwang, K Y Jung, J O Choi; J Korean Cancer Assoc. 2000;32(2):382-389.

Abstract PDF: PURPOSE
p27Kip1 negatively regulates cell proliferation by mediating cell cycle arrest in Gl and Ki-67 is a reliable cellular proliferative index. Also Bcl-2, an inhibitor of apoptosis, has potential activity toward cell survival. The present study investigated p27Kip1, Ki-67 and Bcl-2 expression in adenoid cystic carcinoma for their usefulness of indicator in tumor progression and aggressiveness.
MATERIALS AND METHODS
Formalin-fixed paraffin-embedded surgical specimens were obtained from seventeen patients with adenoid cystic carcinoma. We performed immunohistochemical staining with p27Kip1, Ki-67 and Bcl-2 monoclonal antibodies and compared with patients clinicopathologic features.
RESULTS
There were significant correlation between low p27Kip1 expression and high grade and T classification, positive nodal status and perineural invasion and high stages. However, Ki-67 and Bcl-2 expression had no significant differences in clinicopathologic features and p27Kip1 expression.
CONCLUSION
p27Kip1 is a good reliable marker of tumor progression and aggressiveness in adenoid cystic carcinomas.

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