While the five-year survival rate for adenoid cystic carcinoma (ACC) is relatively high, this cancer has a high risk of recurrence. Therapeutic options are needed to manage this cancer and prevent recurrence. An article in The ASCO Post shared data from Dr. Renata Ferrarotto on a Phase 2 clinical study evaluating a combination treatment of avelumab and axitinib for recurrent or metastatic ACC. In findings published in the Journal of Clinical Oncology, Dr. Ferrarotto and her team discuss the treatment responses. 

Altogether, 28 individuals with recurrent or metastatic ACC enrolled in this clinical trial. To participate, these individuals must have experienced some disease progression over the last six months. During the trial, which took place over a 2-year period, participants received 5mg axitinib twice daily, as well as 10mg/kg avelumab on two specific days of the treatment cycles. The study found that:

• 14 participants experienced disease stability, leading to a disease control rate of 71%. 
• 6 patients experienced partial responses, with 2 patients experiencing their partial responses after a 6-month period. 
• On average, patients experienced progression-free survival for 7.3 months. The median overall survival for those within this study was 16.6 months. 
• The treatment regimen was generally safe and somewhat well-tolerated. 12% of individuals discontinued avelumab treatment due to adverse reactions. 
• Side effects from the treatment combination included fatigue, high blood pressure, diarrhea, deep-vein thrombosis (DVT), and redness, blistering, and inflammation on the hands and feet. 

The research team suggests that additional research is needed to determine whether this treatment combination could actually benefit patients. 

About Adenoid Cystic Carcinoma (ACC)

Adenoid cystic carcinoma is a rare form of glandular tissue cancer. While it most commonly manifests in the salivary glands, ACC may also form in breast or uterine tissue. ACC tumors have a distinctive “nest” pattern filled with a mucous-like material. While ACC grows slowly, it is also aggressively invasive and prone to recurrence. Doctors are not sure of the exact cause of adenoid cystic carcinoma. While some hypothesize that a blend of genetic predisposition and environmental factors play a role, no risk factors have been identified. Symptoms vary based on the tumor’s location. Potential symptoms may, but do not always, include:

• A lump that can be felt
• Localized swelling (with or without pain) in the affected area 
• Painless masses in/on the mouth and face
• Facial numbness or drooping 
• Hair loss
• Difficulty breathing 
• Vision loss
• Hoarseness
• Abnormal vaginal bleeding
• Bulging eye(s) 

Given the various locations where ACC may arise, the above is not a comprehensive list of symptoms. Treatment options include radiation, chemotherapy, surgery, or investigational therapies.