SNUC-i

Sinonasal undifferentiated carcinomas (SNUC) are rare paranasal tumors that have been gathering under one roof on the Houston Shore. This large series from MD Anderson describes a relatively uniform treatment approach spanning many years and nearly 100 patients. And these were bad cases: 69% of patients had T4 disease and 14% nodal disease. The standard approach was cisplatin-based induction chemo followed by either chemoradiation (CRT) or surgery depending on response. Overall, roughly two-thirds of patients had a response to induction chemo. Most responders got definitive CRT while nonresponders generally had surgery plus adjuvant CRT. Supporting this concept of using initial response as a predictive marker, responders treated with definitive CRT rather than surgery had better local and distant control as well as survival with 81% versus 54% rates of cancer-specific survival at 5 years, respectively. TBL: For a disease lacking data, this large series demonstrates a relatively successful approach to treatment for SNUC based on response to induction chemo. | Amit, J Clin Oncol 2019