{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:40:49Z","timestamp":1790095249162,"version":"4.0.1"},"reference-count":76,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T00:00:00Z","timestamp":1727568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>There is currently no effective treatment strategy for recurrent\/metastatic adenoid cystic carcinoma (R\/M ACC). Furthermore, recent single-agent and combination immunotherapy trials have failed in unselected ACC cohorts, unlike non-ACC salivary gland cancers. Genomic profiling revealed no actionable targets but NOTCH1 and KDM6A frameshift and CTCF splice site mutations (no MYB\/L fusion) with a low tumor mutational burden (TMB), microsatellite stable (MSS) and negative programmed death ligand 1 (PD-L1) were observed. We recommended an anti-programmed cell death protein 1 (anti-PD-1) plus anti-Cytotoxic T-lymphocyte-associated protein 4 (anti-CTLA-4) combination based on TMB 2-fold greater-than-median TMB in ACC, tumor harboring multiple immunogenic frameshift or splice site mutations, and PD-L1 negativity. Accordingly, we achieved a complete response in a radiotherapy (RT) and chemotherapy (CT)-refractory patient with locally recurrent lacrimal gland (LG) ACC and lung metastasis following personalized immunotherapy in combination with integrative therapeutics. Therefore, it is crucial to assess not only conventional immune biomarkers but also patient-specific parameters, especially in \u201cimmune-cold\u201d cancer types.<\/jats:p>","DOI":"10.3390\/curroncol31100434","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T10:00:47Z","timestamp":1727690447000},"page":"5838-5849","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Personalized Immunotherapy Achieves Complete Response in Metastatic Adenoid Cystic Carcinoma Despite Lack of Conventional Biomarkers"],"prefix":"10.3390","volume":"31","author":[{"given":"\u00dcnal Metin","family":"Tokat","sequence":"first","affiliation":[{"name":"Medicana Health Group, Precision Oncology Center, 34750 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0505-1558","authenticated-orcid":false,"given":"Ashkan","family":"Adibi","sequence":"additional","affiliation":[{"name":"Medicana Health Group, Precision Oncology Center, 34750 Istanbul, T\u00fcrkiye"},{"name":"Division of Cancer Genetics, Department of Basic Oncology, Institute of Oncology, Istanbul University, 34093 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7850-0177","authenticated-orcid":false,"given":"Esranur","family":"Ayd\u0131n","sequence":"additional","affiliation":[{"name":"Medicana Health Group, Precision Oncology Center, 34750 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyl\u00fcl","family":"\u00d6zg\u00fc","sequence":"additional","affiliation":[{"name":"Medicana Health Group, Precision Oncology Center, 34750 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9574-1471","authenticated-orcid":false,"given":"\u015eevval Nur","family":"Bilgi\u00e7","sequence":"additional","affiliation":[{"name":"Medicana Health Group, Precision Oncology Center, 34750 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onur","family":"Tutar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, 34098 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merve","family":"\u00d6zbek Do\u011fan\u00e7ay","sequence":"additional","affiliation":[{"name":"Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, 34020 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130rem","family":"Demiray","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology and Genetics, Koc University, 34450 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2501-3097","authenticated-orcid":false,"given":"Mutlu","family":"Demiray","sequence":"additional","affiliation":[{"name":"Medicana Health Group, Precision Oncology Center, 34750 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"597","DOI":"10.3322\/caac.21807","article-title":"The evolving landscape of salivary gland tumors","volume":"73","author":"Steuer","year":"2023","journal-title":"CA Cancer J. 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