Northfield, Ill. (March 5, 2025) — Advancements in molecular testing are revolutionizing the diagnosis and treatment of salivary gland neoplasms, providing physicians and patients with unprecedented precision in care. With salivary gland tumors accounting for only 5% of head and neck cancers worldwide, these rare malignancies have historically been difficult to diagnose and treat. However, a new article from the College of American Pathologists (CAP), outlines how cutting-edge molecular profiling is changing that narrative, leading to enhanced diagnostic accuracy, improved prognostication, and targeted therapeutic options.
“Molecular testing methodologies have improved the diagnostic and therapeutic approach of salivary gland neoplasms by enhancing diagnostic accuracy and enabling targeted therapies through biomarker testing,” said CAP member and co-author Gloria H. Sura, MD, FCAP.
The latest research highlights how recurring genetic alterations in salivary gland neoplasms—both mutations and structural rearrangements—serve as key clinical indicators. These biomarkers assist in distinguishing complex cases, guiding surgical and targeted therapy decisions, evaluating treatment responses, and determining patient eligibility for clinical trials.
Key Findings:
- Diagnostic Advancements: Fine needle aspiration (FNA) cytology, combined with next-generation sequencing (NGS) and other molecular testing techniques, enhances accuracy in diagnosing salivary gland neoplasms.
- Genetic Alterations and Therapeutic Targets: Specific gene alterations, including NR4A3, MYB::NFIB, and ETV6::NTRK3 fusions, are highly indicative of certain tumor types and may be used to aid in their diagnosis. Emerging targeted therapies, such as TRK and HER2 inhibitors, are showing promising clinical outcomes in patients with tumors harboring certain molecular biomarkers.
- Prognostic Insights: Alterations in TP53, HER2/ERBB2, and MAML2 are linked to varying prognoses, with some markers suggesting a more aggressive disease course while others indicate better survival rates in specific tumor types.
A Future of Personalized Treatment
“As molecular profiling continues to advance, it is paving the way for a future in which every patient with a salivary gland tumor receives a diagnosis and treatment plan tailored to their tumor’s unique genetic profile,” shared CAP member and co-author, Jessica S. Thomas, MD, PhD, MPH, BS, FCAP. “By integrating molecular testing into routine clinical practice, clinicians can make more informed decisions, improving outcomes for patients with these rare and complex malignancies.”
About the College of American Pathologists
As the world’s largest organization of board-certified pathologists and leading provider of laboratory accreditation and proficiency testing programs, the College of American Pathologists (CAP) serves patients, pathologists, and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine worldwide. For more information, visit the CAP Newsroom, CAP.org and yourpathologist.org to watch pathologists at work and see the stories of the patients who trust them with their care.
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