Carcinoma da glândula salivar
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| ID | DIS-SALIVARY |
|---|---|
| Tipo | Doença |
| Alegais | Carcinoma cístico adenoideMASC (carcinoma analógico mamário secretor)Carcinoma do ducto salivarCâncer da glândula salivarКарцинома слинних залоз |
| Estado | reviewed 2026-04-27 | pending_clinical_signoff |
| Doenças | Nenhuma declaração |
| Fontes | SRC-NCCN-NSCLC-2025 |
Informational support. All recommendations must be verified by a qualified oncologist. Engineering checks are not clinical validation or treatment approval.
| icd_o_3_morphology | 8500/3 |
|---|---|
| icd_o_3_topography | ["C07", "C08"] |
| icd_10 | C07, C08 |
| who_classification | WHO Head and Neck Tumours 5th ed (2024): Salivary gland tumours (>25 distinct histologic entities) |
Notas
Umbrella disease; therapy is HISTOLOGY-driven. Two histologies are highly actionable: - Mammary analogue secretory carcinoma (MASC, parotid most common): near-100% ETV6-NTRK3 fusion (or NTRK1/2 partner variants); larotrectinib / entrectinib transformative in advanced disease (FDA tumor-agnostic). - Salivary duct carcinoma (SDC): aggressive, often parotid; molecular profile mimics breast / prostate: * AR-positive (~70-80%): bicalutamide + LHRH agonist (EORTC-1206); active even without prior antiandrogen exposure. * HER2-amplified (~30-40%): trastuzumab + docetaxel (Takahashi et al, JCO 2019); trastuzumab deruxtecan in DESTINY-PanTumor02; zanidatamab. * HRAS mutant (~10-15%): tipifarnib (KO-TIP-007). * PIK3CA / PI3K pathway: alpelisib + tipifarnib in KURRENT-HN. - Adenoid cystic carcinoma (ACC): MYB-NFIB fusion ~60% (not currently drugged); NOTCH1 mutation ~15% (gamma-secretase inhibitors — AL101 / ACCURACY trial). Indolent course with late distant relapses (lung most common). Chemotherapy generally low-yield; multikinase TKIs (lenvatinib) modest activity. - Mucoepidermoid carcinoma: CRTC1-MAML2 fusion ~50% (prognostic, not therapeutic). Surgery + adjuvant RT for high-grade.
Usado por
Relevância terapêutica
BMA-NTRK-ETV6-SALIVARY- ETV6-NTRK3 é a fusão definidora do carcinoma analógico de secret...BMA-NTRK-FUSION-SALIVARY- fusão NTRK em tumores de glândulas salivares — praticamente 100% de secretariado analógico mamário...
Algoritmos
ALGO-SALIVARY-1L- ALGO-SALIVARY-1L
Indicação
IND-SALIVARY-PALLIATIVE-PACLITAXEL-CARBO- IND-SALIVARY-PALLIATIVE-PACLITAXEL-CARBO
Questionários
QUEST-SALIVARY-1L-STUB- Carcinoma da glândula salivar — primeira linha
Sinal de alerta
RF-SALIVARY-ADVANCED-PALLIATIVE- Carcinoma da glândula salivar metastático com ECOG ≥3 OR progressão rápida — sup...RF-SALIVARY-FRAILTY-AGE- Age ≥75 with ECOG ≥2 or ≥2 comorbidities — cisplatin + RT and trastuzumab + chemotherapy...RF-SALIVARY-HIGH-RISK-BIOLOGY- Carcinoma da glândula salivar com condutor molecular acionável: fusão ETV6-NTRK3 (aná...RF-SALIVARY-INFECTION-SCREENING- Infecção activa ou latente que necessita de resolução / profilaxia antes de iniciar cisplatin...RF-SALIVARY-ORGAN-DYSFUNCTION- Baseline organ dysfunction precluding standard cisplatin-based chemotherapy or affecting...RF-SALIVARY-TRANSFORMATION-PROGRESSION- Progressão do carcinoma da glândula salivar: transformação de alto grau (adenoide de baixo grau cístico...
Revisores
REV-DENISOVA-OLGA- {"english": "Olga Denisova", "preferido": "Olga Denisova", "sufixo": "MD", "ukrainian": "...