Treatment of Advanced Adenoid Cystic Carcinoma of the Trachea with Significant Disease Progression and Symptoms
Adenoid cystic carcinoma (ACC) is one of the two most common primary tracheal malignancies in adults — together with squamous-cell carcinoma, the two types account for more than two-thirds of primary tracheal tumours. When ACC of the trachea progresses to an advanced stage with significant disease progression and symptoms, systemic treatment becomes a central consideration.
Clinical scenario
Advanced adenoid cystic carcinoma of the trachea with significant disease progression and symptoms. Evidence-based guidelines support the use of systemic chemotherapy for patients in this setting, where both the pace of progression and the patient's symptom burden indicate a need for active systemic intervention.
Treatment approach — partial overview
For patients with advanced ACC of the trachea exhibiting significant disease progression and symptoms, multi-agent chemotherapy is the recommended approach. A specific combination regimen is used in this setting — the full composition, sequencing, and clinical parameters are outlined in the complete protocol.
References
DOI: 10.3389/or.2024.1451247
- The most common types are squamous-cell carcinoma (SCC) and adenoid cystic carcinoma (ACC), which together account for more than two-thirds of primary tracheal tumors in adults.
- Consider multi-agent chemotherapy for patients with advanced ACC exhibiting significant disease progression and symptoms [II, B].
- In patients with symptoms of advanced disease, multi-agent chemotherapy may be considered.
- The regimen most commonly used is the CAP regimen (cisplatin, doxorubicin, cyclophosphamide) regimen, with objective response rates of approximately 25% and response times of 6–77 months.
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