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AuthorGargano, Stacey M
AuthorSenarathne, Wijendra
AuthorFeldman, Rebecca
AuthorFlorento, Elena
AuthorStafford, Phillip
AuthorSwensen, Jeffrey
AuthorVranic, Semir
AuthorGatalica, Zoran
Available date2019-10-15T11:01:04Z
Publication Date2019-10-14
Publication NameCancer Medicineen_US
Identifierhttp://dx.doi.org/10.1002/cam4.2602
CitationGargano, SM, Senarathne, W, Feldman, R, et al. Novel therapeutic targets in salivary duct carcinoma uncovered by comprehensive molecular profiling. Cancer Med. 2019; 00: 1– 8. https://doi.org/10.1002/cam4.2602
URIhttp://hdl.handle.net/10576/12121
AbstractSalivary duct carcinoma (SDC) is a rare, aggressive salivary gland malignancy, which often presents at an advanced stage. A proportion of SDC are characterized by HER2 amplification and/or overexpression of androgen receptor (AR), which could be targeted in a subset of patients, but the presence of AR splice variant-7 (AR-V7) in some SDC cases could result in resistance to anti-androgen therapy. We evaluated a cohort of 28 cases of SDC for potentially targetable biomarkers and pathways using immunohistochemistry (IHC) and next-generation sequencing (DNA and RNA) assays. Pathogenic genetic aberrations were found in all but 1 case and affected TP53 (n = 19), HRAS (n = 7), PIK3CA, ERBB2 (HER2), and NF1 (n = 5 each); KMT2C (MLL3) and PTEN (n = 3 each); BRAF (p.V600E), KDM5C and NOTCH1 (n = 2 each). Androgen receptor was expressed in all cases and 13 of 27 harbored the AR-V7 splice variant (including a case without any other detectable genetic alteration). HER2 IHC was expressed in 11 of 28 cases. The majority of SDC cases had no biomarkers predictive of immunotherapy response: 5 cases exhibited low (1%-8%) programmed death ligand 1 (PD-L1) expression in tumor cells, 2 cases exhibited elevated TMB, and no samples exhibited microsatellite instability. Notably, the pre-treatment biopsies from 2 patients with metastatic disease, who demonstrated clinical responses to anti-androgen therapy, showed AR expression and no AR splice variants. We conclude that comprehensive molecular profiling of SDCs can guide the selection of patients for targeted therapies involving AR, HER2, PD-L1, mitogen-activated protein kinase, and PIK3CA pathways.
Languageen
PublisherWiley Open Access
Subjectbiomarkers
Subjecthead and neck cancer
Subjectmolecular genetics
Subjectnext generation sequencing
Subjectsalivary glands
TitleNovel therapeutic targets in salivary duct carcinoma uncovered by comprehensive molecular profiling.
TypeArticle
Pagination1– 8
ESSN2045-7634


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