Abstract

Treatment options for unresectable, recurrent or metastatic salivary gland carcinomas (SGC) are scarce. Trophoblast cell surface antigen 2 (Trop-2) is a transmembrane glycoprotein that is involved in a variety of oncogenic cell signaling pathways. Its potential as a target for the antibody–drug conjugate sacituzumab govitecan has already been demonstrated in different tumor entities. The United States Food and Drug Administration approved this antibody–drug conjugate for the treatment of metastatic triple-negative breast cancer. Here, we aimed to investigate Trop-2 protein expression in different entities of SGCs. We retrospectively reviewed the medical records of all patients that underwent surgery for a primary SGC in a tertiary referral center between 1990 and 2014. Immunohistochemical (IHC) staining for Trop-2 was performed and rated as negative, weak, moderate or high using a semiquantitative score. Additionally, representative cases were analyzed using MALDI-mass spectrometry (MS) imaging to confirm the IHC results. The cohort consisted of 114 tumors of the parotid gland (90.4%) and submandibular gland (9.6%). It mainly included mucoepidermoid, salivary duct and adenoid cystic carcinomas. In IHC samples, 44% showed high, 38% moderate and 10% weak expression rates of Trop-2. MALDI-MS imaging confirmed the presence of Trop-2 protein in 80% of the tested tumor samples. This is the first study to demonstrate that several types of SGC express Trop-2 with variable intensity. Since there are currently few systemic treatment options for advanced SGCs, Trop-2 represents a promising target for further clinical studies, for instance, with sacituzumab govitecan.

Highlights

  • Salivary gland carcinomas (SGC) consist of a heterogeneous group of more than a dozen tumors

  • The aim of the current study was to test for the extent, distribution and intensity of Trophoblast cell surface antigen 2 (Trop-2) protein expression in different entities of SGCs using a bimodal approach of immunohistochemistry and matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS) imaging

  • Trop-2 is a transmembrane protein with an extracellular domain and its expression is upregulated in tumors cells relative to normal cells [23]

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Summary

Introduction

Salivary gland carcinomas (SGC) consist of a heterogeneous group of more than a dozen tumors. All authors contributed substantially to the paper in conception, design and writing. In advanced-stage tumors (T3-4), high-grade tumors, positive or close margins or in the presence of lymph node metastasis, vascular and perineural invasion, adjuvant radiation therapy is indicated [4, 5]. For adenoid cystic carcinoma and other high-risk pathologies (e.g., high-grade mucoepidermoid carcinoma, salivary duct carcinoma), especially those arising in anatomic sites not amenable to wide resection, such as the nasal cavity and paranasal sinuses, many authors recommend adjuvant radiation therapy to increase local control rates even after complete resection due to the tumors’ aggressive and often perineural growth [4, 6,7,8,9,10].

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