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Cancers & treatments·Sequencing

Salivary duct carcinoma: lines of therapy

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4 standard-of-care settings across 3 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersHER2
Early / localised1·
Advanced, first line11
Other settings1·

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
All comersLocalised, resectableTotal parotidectomy (or resection of the affected gland) with facial nerve sacrifice where involved, neck dissection and postoperative radiotherapy, with cisplatin for extranodal extension or positive margins.
IMRT / IGRT (modern external beam)CisplatinChemoradiation (chemoradiotherapy, CRT)
93

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersAndrogen receptor-positive recurrent or metastaticAndrogen deprivation with leuprorelin and bicalutamide; enzalutamide or apalutamide as alternatives or after progression.
Leuprolide (leuprorelin) and GnRH agonistsBicalutamideEnzalutamideApalutamideAndrogen deprivation & AR pathway inhibitorsA Study of Apalutamide Combined With GnRH Agonist in Participants With Androgen Receptor Positive Salivary Gland Carcinoma
95
HER2HER2-positive recurrent or metastaticTrastuzumab with docetaxel (phase 2, response rate 70 percent); trastuzumab deruxtecan on progression or as an alternative.
TrastuzumabDocetaxelTrastuzumab deruxtecanHER2
97

Other settings

SubgroupSettingApproachProducts and trialsEvidence
All comersMarker-negative or after targeted treatmentPlatinum-based chemotherapy (carboplatin-paclitaxel or cisplatin-based); pembrolizumab for PD-L1-positive, mutation-rich or mismatch repair-deficient tumours.
CisplatinCarboplatinPaclitaxel / nab-paclitaxelPembrolizumab
98

Sequence and caution pairings

CautionApproved
Caution: DXd ADC + agents with pneumonitis risk

Enhertu and its DXd cousins can inflame the lungs; combining them with immunotherapy, radiation, or mTOR inhibitors stacks that risk.

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.