Efficacy and toxicity of sorafenib in patients with adenoid cystic carcinoma of the head and neck: a case series of five patients

Acta Clin Belg. 2020 Oct;75(5):362-369. doi: 10.1080/17843286.2019.1633490. Epub 2019 Jun 23.

Abstract

Introduction: Adenoid cystic carcinoma (ACC) of the head and neck is a rare malignancy of the salivary glands that accounts for approximately 10% of salivary gland carcinoma. Despite aggressive local therapy, local recurrence and distant metastases occur frequently. Response rates (RR) to potential curative and palliative chemotherapy are limited, so new strategies are needed.

Case reports: We describe five case reports of patients with unresectable locally advanced or metastatic ACC of the head and neck who have been treated with sorafenib, a multi-tyrosine kinase inhibitor (mTKI).

Results: In this case series, we found that three out of five patients treated with sorafenib survived, respectively, 16, 35 and 35 months. Two patients showed a partial response (PR) and one patient had a prolonged stable disease (SD) for almost three years. Grade 3 adverse events (AE) occur under sorafenib so adequate toxicity management is essential. This retrospective case series hints towards the possibility of clinical benefit for treating ACC patients with sorafenib. Efficacy of sorafenib should be studied in a prospective-randomized clinical trial which is a challenging task due to the rarity of the disease.

Keywords: Adenoid cystic carcinoma; Sorafenib; salivary gland carcinoma; targeted therapy; tyrosine kinase inhibitor.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Bone Neoplasms / drug therapy
  • Bone Neoplasms / secondary
  • Carcinoma, Adenoid Cystic / drug therapy*
  • Carcinoma, Adenoid Cystic / pathology
  • Carcinoma, Adenoid Cystic / secondary
  • Fatigue / chemically induced
  • Female
  • Hand-Foot Syndrome / etiology
  • Humans
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / secondary
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / secondary
  • Lymph Nodes
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Mucositis / chemically induced
  • Neoplasm Recurrence, Local
  • Pericardium
  • Pleural Neoplasms / drug therapy
  • Pleural Neoplasms / secondary
  • Progression-Free Survival
  • Retrospective Studies
  • Salivary Gland Neoplasms / drug therapy*
  • Salivary Gland Neoplasms / pathology
  • Sorafenib / therapeutic use*

Substances

  • Antineoplastic Agents
  • Sorafenib