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Personalized Immunotherapy Achieves Complete Response in Metastatic Adenoid Cystic Carcinoma Despite Lack of Conventional Biomarkers.

Authors :
Tokat, Ünal Metin
Adibi, Ashkan
Aydın, Esranur
Özgü, Eylül
Bilgiç, Şevval Nur
Tutar, Onur
Özbek Doğançay, Merve
Demiray, İrem
Demiray, Mutlu
Source :
Current Oncology; Oct2024, Vol. 31 Issue 10, p5838-5849, 12p
Publication Year :
2024

Abstract

There is currently no effective treatment strategy for recurrent/metastatic adenoid cystic carcinoma (R/M ACC). Furthermore, recent single-agent and combination immunotherapy trials have failed in unselected ACC cohorts, unlike non-ACC salivary gland cancers. Genomic profiling revealed no actionable targets but NOTCH1 and KDM6A frameshift and CTCF splice site mutations (no MYB/L fusion) with a low tumor mutational burden (TMB), microsatellite stable (MSS) and negative programmed death ligand 1 (PD-L1) were observed. We recommended an anti-programmed cell death protein 1 (anti-PD-1) plus anti-Cytotoxic T-lymphocyte-associated protein 4 (anti-CTLA-4) combination based on TMB 2-fold greater-than-median TMB in ACC, tumor harboring multiple immunogenic frameshift or splice site mutations, and PD-L1 negativity. Accordingly, we achieved a complete response in a radiotherapy (RT) and chemotherapy (CT)-refractory patient with locally recurrent lacrimal gland (LG) ACC and lung metastasis following personalized immunotherapy in combination with integrative therapeutics. Therefore, it is crucial to assess not only conventional immune biomarkers but also patient-specific parameters, especially in "immune-cold" cancer types. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
11980052
Volume :
31
Issue :
10
Database :
Complementary Index
Journal :
Current Oncology
Publication Type :
Academic Journal
Accession number :
180556895
Full Text :
https://doi.org/10.3390/curroncol31100434