Tokat, Ü. M.; Adibi, A.; Aydın, E.; Özgü, E.; Bilgiç, Ş. N.; Tutar, O.; Özbek Doğançay, M.; Demiray, İ.; Demiray, M. Personalized Immunotherapy Achieves Complete Response in Metastatic Adenoid Cystic Carcinoma Despite Lack of Conventional Biomarkers. Preprints2024, 2024080349. https://doi.org/10.20944/preprints202408.0349.v1
APA Style
Tokat, Ü. M., Adibi, A., Aydın, E., Özgü, E., Bilgiç, Ş. N., Tutar, O., Özbek Doğançay, M., Demiray, İ., & Demiray, M. (2024). Personalized Immunotherapy Achieves Complete Response in Metastatic Adenoid Cystic Carcinoma Despite Lack of Conventional Biomarkers. Preprints. https://doi.org/10.20944/preprints202408.0349.v1
Chicago/Turabian Style
Tokat, Ü. M., İrem Demiray and Mutlu Demiray. 2024 "Personalized Immunotherapy Achieves Complete Response in Metastatic Adenoid Cystic Carcinoma Despite Lack of Conventional Biomarkers" Preprints. https://doi.org/10.20944/preprints202408.0349.v1
Abstract
There is currently no effective treatment strategy for the 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 TMB, MSS and negative PD-L1. We recommended anti-PD-1 plus 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 and chemotherapy-refractory patient with locally recurrent lacrimal gland 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.
Medicine and Pharmacology, Oncology and Oncogenics
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