Mucoepidermoid carcinoma
Prepared with OnCo (onco.cc/prep/mucoepidermoid-carcinoma/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
17 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example MAML2 rearrangement by FISH, Histological grade, Margin status and perineural invasion, Nodal spread and extranodal extension, Ki-67), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (low-grade, localised), which of the standard options do you recommend and why?
- 6.For my situation (intermediate- and high-grade or node-positive), which of the standard options do you recommend and why?
- 7.Am I a candidate for Cisplatin, and what side effects should I expect?
- 8.For my situation (recurrent or metastatic), which of the standard options do you recommend and why?
- 9.Am I a candidate for Cisplatin, Carboplatin, Paclitaxel / nab-paclitaxel or related drugs, and what side effects should I expect?
- 10.For my situation (trials), which of the standard options do you recommend and why?
- 11.Am I a candidate for Gotistobart, and what side effects should I expect?
- 12.How do the results of A Study of Emiltatug Ledadotin (Emi-Le) in Participants With Solid Tumors apply to someone like me?
- 13.Are there clinical trials I could join, for example of Gotistobart, A Study of Emiltatug Ledadotin (Emi-Le) in Participants With Solid Tumors, Pembrolizumab?
- 14.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 15.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 16.I read that “No targeted drug for the MAML2 fusion”. How does that affect my plan?
- 17.I read that “Grading systems disagree, so treatment intensity varies between centres”. How does that affect my plan?
The words I may hear
- PD-L1 expression testing (22C3, SP142, SP263): A stain on the tumour biopsy that measures how much of the PD-L1 'don't attack me' protein is present, scored as a tumour proportion or combined positive score.
- Extranodal extension (ENE): Extranodal extension means cancer in a lymph node has burst through the node's capsule into the surrounding fat; in head and neck cancer it is the single finding after surgery that most often turns radiotherapy into chemoradiotherapy, and in HPV-negative disease it moves the stage up.
- Chemoradiation (chemoradiotherapy, CRT): Radiotherapy given at the same time as chemotherapy, which sensitises the cancer to radiation.
Tests and results to bring
Biomarker results to ask for: MAML2 rearrangement by FISH (confirms the diagnosis), Histological grade (AFIP or Brandwein system), Margin status and perineural invasion, Nodal spread and extranodal extension, Ki-67.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Low-grade, localised: Complete excision with a margin (parotidectomy preserving the facial nerve, or excision of the minor gland lesion); postoperative radiotherapy only for positive margins that cannot be re-excised. (IMRT / IGRT (modern external beam))
- Intermediate- and high-grade or node-positive: Resection with neck dissection and postoperative radiotherapy; cisplatin chemoradiation considered for extranodal extension or positive margins. (IMRT / IGRT (modern external beam), Cisplatin, Chemoradiation (chemoradiotherapy, CRT))
- Recurrent or metastatic: Platinum-based chemotherapy (carboplatin-paclitaxel or cisplatin-based); pembrolizumab for PD-L1-positive or mutation-rich tumours; observation for indolent low-grade metastases. (Cisplatin, Carboplatin, Paclitaxel / nab-paclitaxel, Pembrolizumab, PD-L1 expression testing (22C3, SP142, SP263))
- Trials: Pan-salivary and pan-tumour trials of new agents that accept mucoepidermoid carcinoma. (Gotistobart, A Study of Emiltatug Ledadotin (Emi-Le) in Participants With Solid Tumors)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.