Sinonasal undifferentiated carcinoma (SNUC) and SWI/SNF-deficient sinonasal carcinoma: lines of therapy
5 standard-of-care settings across 4 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
| Line | All comers |
|---|---|
| Screening, prevention and diagnosis | 1 |
| Locally advanced | 1 |
| Advanced, first line | 2 |
| Second line | 1 |
Screening, prevention and diagnosis
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Diagnosis | Biopsy with immunohistochemistry (cytokeratins, NUT, INI1, SMARCA4, neuroendocrine markers, EBER) and IDH2 testing; MRI and CT of the sinuses, skull base and neck; PET-CT. | NCCN Guidelines: Head and Neck Cancers (ethmoid and maxillary sinus tumours) | 95 |
Locally advanced
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Locally advanced disease, first step | Induction chemotherapy with cisplatin and etoposide (or docetaxel-platinum) for two to three cycles. | NCCN Guidelines: Head and Neck Cancers (ethmoid and maxillary sinus tumours) | 94 |
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Responders to induction | Definitive chemoradiotherapy with concurrent cisplatin (intensity-modulated or proton), including elective neck irradiation. | NCCN Guidelines: Head and Neck Cancers (ethmoid and maxillary sinus tumours) | 93 | |
| All comers | Non-responders to induction | Surgical resection where feasible followed by radiotherapy or chemoradiotherapy. | NCCN Guidelines: Head and Neck Cancers (ethmoid and maxillary sinus tumours) | 93 |
Second line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Metastatic or recurrent disease | Platinum-etoposide; PD-1 antibodies (pembrolizumab, nivolumab) on case series evidence; enasidenib for IDH2-mutant tumours in trials; EZH2 inhibitors for SWI/SNF-deficient carcinoma in trials. | NCCN Guidelines: Head and Neck Cancers (ethmoid and maxillary sinus tumours) | 99 |
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.