Decoding the genomic landscape of adenoid cystic carcinoma: a retrospective cohort study of MYB family alterations, NOTCH pathway activation, and clinical outcomes

Concurrent MYB and NOTCH alterations define a molecularly aggressive ACC subset requiring intensified surveillance. These findings advocate for routine molecular stratification to guide adjuvant therapy selection. While other clinical factors (e.g., T stage) contribute to prognosis, these alterations identify patients who may benefit from dual-pathway inhibitors. Prospective validation is needed to confirm clinical utility.