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

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
• salivary gland carcinoma
• Sorafenib
• targeted therapy
• tyrosine kinase inhibitor

Disclosure statement

• dr. Couvreur Karen: no declaration of interest

• dr. Jacobs Celine: no declaration of interest

• dr. De Bock Marlies: no declaration of interest

• dr. Dhondt Randal: no declaration of interest

• prof. dr. Deron Philippe: no declaration of interest

• prof. dr. Duprez Frederic: no declaration of interest

• prof. dr. Rottey Sylvie:Declaration of interest: Bayer

• Fees Bayer: speakers fee and adboard participation

Additional information

Notes on contributors

Karen Couvreur

Dr. Karen Couvreur is a medical oncologist currently working in AZ Damiaan in Ostend. She finished her studies of medical oncology in 2018 at the department of medical oncology in UZ Gent.

Jacobs Celine

Dr. Jacobs Celine is a resident of medical oncology in the UZ Gent. She will graduate in 10/2019.

Bock Marlies

Dr. De Bock Marlies is a medical oncologist currently working in AZ Delta in Roeselare. She finished her studies of medical oncology in 2018 at the department of medical oncology in UZ Gent.

D’Hondt Randal

Dr. D’Hondt Randal is the head of department of medical oncology in AZ Damiaan Ostend. In 2001 he founded the Medical Oncology – Hematology department in Az Damiaan and further developed it into a very active, growing service that is open to innovative initiatives.

Deron Philippe

Prof dr. Deron Philippe is the head of department of head a neck in UZ Gent. He is a head and neck surgeon who is specialized in oncologic surgeries of the head and neck regions.

Duprez Frederic

Prof. dr. Duprez Frederic is the head of clinic in the department of radiation therapy in UZ Gent. He is a radiation specialist who is specialised in treating patients with head and neck cancer and endocrinological malignancies.

Rottey Sylvie

Prof. dr. Rottey Sylvie is the head of clinic in the department of medical oncology and head of the Drug Research Unit Ghent in the UZ Gent. She is a medical oncologist who is specialized in head and neck cancers and urogenital cancers.