905P - Hot topics in salivary gland carcinomas treatment: An EORTC young investigator and early career investigator survey

Background

Recently, ASCO and ESMO guidelines on Salivary Gland Carcinomas (SGCs) have been released. Several crucial points lack strong recommendations, due to low or intermediate quality of evidence. We conducted a survey in the EORTC Head and Neck Cancer Group (HNCG) members, on behalf of the EORTC Young and Early Career Investigator to better address such “grey zones” of the guidelines.

Methods

The survey included 29 questions, covering diagnostic and therapeutic issues of SGC patients and was shared among 539 members of the EORTC HNCG. Responses were collected from December 2022 to March 2023. The primary aim was to evaluate decision criteria guiding physician’s on areas of low evidence of SGCs guidelines.

Results

Among 102 responders, aged 40-55 years (55%), 45%, 28%, 22%, and 5% were medical oncologists, radiation oncologists, ENT surgeons, and other specialists, respectively. Respondents were distributed across Europe (mainly Italy 19%, Belgium 10%, and Spain 8%). Chemoradiotherapy (CRT) in the definitive and adjuvant (adj) settings in case of pathological high risk features was recommended by 35% and 30% of them, respectively. In case of R0 resection of highly aggressive SGC, at pT1-2 stage, 37% proposed close follow up, while 38% proposed adj lymph node (LN) field RT; for pT3-4 stage, 48% proposed adj LN field RT in all cases, and 44% proposed adj LN field RT only based on risk factors. After salvage surgery for locoregional relapse, the most important factors guiding decision to give adj RT were previous radiotherapy, margin status, and presence of extranodal extension. Fifty% of respondents would propose adjuvant antiHER2 or anti androgen receptor (AR) treatment within clinical trial (if positive receptor status). In case of combined positivity to HER2 and AR, responses were heterogeneous regarding the choice for first-line treatment.

Conclusions

Due to a lack of high-level evidence, international guidelines do not provide strong recommendations in several fields of SGCs diagnosis and treatment, contributing to inconsistent approaches in clinical practice. Further prospective trials are required to better address these topics.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.