Drug-based therapy for advanced adenoid cystic carcinoma: Current landscape and challenges based on an overview of registered clinical trials

Vivian Petersen Wagner; Renata Ferrarotto; Pablo Agustin Vargas; Manoela Domingues Martins; Colin D Bingle; Lynne Bingle

doi:10.1016/j.critrevonc.2022.103886

Drug-based therapy for advanced adenoid cystic carcinoma: Current landscape and challenges based on an overview of registered clinical trials

Crit Rev Oncol Hematol. 2023 Jan:181:103886. doi: 10.1016/j.critrevonc.2022.103886. Epub 2022 Nov 23.

Authors

Vivian Petersen Wagner¹, Renata Ferrarotto², Pablo Agustin Vargas³, Manoela Domingues Martins⁴, Colin D Bingle⁵, Lynne Bingle⁶

Affiliations

¹ Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK. Electronic address: v.wagner@sheffield.ac.uk.
² Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
³ Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
⁴ Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil; Oral Pathology Department, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
⁵ Academic Unit of Respiratory Medicine, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.
⁶ Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK.

PMID: 36427771
DOI: 10.1016/j.critrevonc.2022.103886

Abstract

Adenoid cystic carcinoma (ACC) has a significant patient-population in need of effective systemic therapy, as no drug is currently approved by the FDA for its management. We critically reviewed ACC-clinical trials (CT) registered on the ClinicalTrials.gov website using "ACC" under condition or disease. Trials specifically designed to test a drug-based therapy for ACC (n = 33) were analyzed with most being one-arm phase II trials enrolling advanced, recurrent/metastatic, incurable ACC cases. Site restriction, maximum ECOG status, and period of disease progression varied as inclusion criteria. Small-molecule inhibitors were those most commonly investigated with Apatinib, Axitinib and Lenvatinib showing the best results in association with rigid enrollment criteria. The overall median time to progression remains modest and more efforts are urgently needed in this field. CTs designed to test drugs that act on key pathways associated with ACC aggressiveness are being conducted and represent a promising pathway if efficacy is proved.

Keywords: Chemotherapy; Head and neck cancer; Oncology; Salivary gland cancer.

Publication types

Review

MeSH terms

Axitinib / therapeutic use
Carcinoma, Adenoid Cystic* / drug therapy
Carcinoma, Adenoid Cystic* / pathology
Clinical Trials as Topic
Humans
Neoplasm Recurrence, Local / drug therapy
Salivary Gland Neoplasms* / pathology

Substances

Axitinib