What`s new in salivary gland cancer research and treatment?

Many medical centers across the nation are doing research on the causes and treatment of salivary gland cancer. This is a challenging disease to study because it is not common and there are many types of salivary gland cancer. But each year, scientists find out more about what causes the disease and how to improve treatment.

Biology of salivary gland cancers

Recent studies have found certain consistent changes in chromosomes and genes of various types of salivary gland cancers. Researchers are learning more about how these changes cause salivary gland cells to become malignant. They have found that in some salivary gland cancer cells, 2 chromosomes have swapped parts of their DNA. This is known as a translocation. These changes often cause activation of genes that control cell growth. For example, adenoid cystic carcinomas often have translocations involving chromosomes 6 and 9; in mucoepidermoid carcinomas, the translocations usually involve chromosomes 11 and 19.

As scientists learn more about these and other DNA, RNA, and protein changes in salivary gland cancers, they hope to use this information to develop new treatments for salivary gland cancers that are more effective and cause fewer side effects.

Treatment

Surgery

Advances in surgical techniques now allow teams of head and neck surgeons and neurosurgeons to remove cancers that have spread near the base of the skull. These operations were not thought possible a few years ago but are becoming more common and successful.

Reconstructive surgery is becoming more sophisticated and successful. This permits more extensive surgery to be done and improves patients' quality of life after treatment.

Radiation therapy

Advances in radiation therapy now permit more precise targeting of radiation. Some types of radiation, such as fast neutron beam radiation have been found to be particularly useful, but they require specialized equipment that is not available in many hospitals.

Chemotherapy

Advanced salivary gland cancer is rare, so knowledge about treating these cancers with chemotherapy (chemo) is still evolving. Chemo drugs such as gemcitabine, capecitabine, and oxaliplatin are now being tested in clinical trials and may provide more options for people with advanced salivary gland cancer.

Targeted therapy

As researchers have learned more about the changes in cells that cause cancer, they have been able to develop newer drugs that specifically target these changes. These targeted drugs work differently than standard chemotherapy drugs. They often have different (and less severe) side effects.

Studies of salivary gland cancer have identified changes in several proteins that promote growth and spread of cancer cells. Some of these changes are more common in particular forms of salivary gland cancer and some affect proteins that can be blocked by targeted therapies that are active against cancer of some other organs. This information is being used to guide clinical trials of targeted therapies for salivary gland cancers and to develop new targeted drugs.

One drug, imatanib (Gleevec®), has shown some promise in treating advanced salivary gland cancers when combined with the chemo drug cisplatin. Studies of other targeted drugs are ongoing.