Systemic therapy for recurrent or metastatic salivary gland malignancies.

Salivary gland carcinomas are notoriously resistant to therapy and no standard of care exists. Due to the rarity of these malignancies, various histologies, and wide ranging clinical behavior it has been difficult to standardize systemic therapy. We have reviewed clinical prospective studies in the last 15 years with salivary gland malignancies involving cytotoxic chemotherapy and biologic agents including targeted therapies such as anti-HER-2, anti-EGFR therapies, and therapies directed at c-kit. Although the results of most trials are modest at best, there has been an increase in studies for salivary cancer in recent years and there are several promising treatment approaches in evolution. Every effort should be made to treat salivary gland malignancies under a clinical protocol and/or at a large multidisciplinary practice with clinicians experienced in treating these malignancies.