Cancer Res Treat.  2024 Oct;56(4):1068-1076. 10.4143/crt.2024.008.

Analysis of Response and Progression Patterns of Tyrosine Kinase Inhibitors in Recurrent or Metastatic Adenoid Cystic Carcinoma: A Post Hoc Analysis of Two KCSG Phase II Trials

• Kim Y
• Keam B
• Kang EJ
• Kim JS
• Kim HR
• Lee KW
• Kwon JH
• Lee KE
• Yang Y
• Choi YH
• Kim MK
• Ji JH
• Yun T
• Choi MY
• Lee KH
• Kim SB
• Ahn MJ

• KMID: 2560241
• DOI: http://doi.org/10.4143/crt.2024.008

Abstract

Purpose
In this study, we evaluated 66 patients diagnosed with adenoid cystic carcinoma (ACC) enrolled in two Korean Cancer Study Group trials to investigate the response and progression patterns in recurrent and/or metastatic ACC treated with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs).
Materials and Methods
We evaluated 66 patients diagnosed with ACC who were enrolled in the Korean Cancer Study Group trials. The tumor measurements, clinical data, treatment outcomes, and progression patterns of therapy were analyzed.
Results
In the 66 patients (53 receiving axitinib and 13 receiving nintedanib), the disease control rate was 61%, and three patients achieved partial response. The median follow-up, median progression-free survival (PFS), overall survival, and 6-month PFS rate were 27.6%, 12.4%, and 18.1% months and 62.1%, respectively. Among 42 patients who experienced progression, 27 (64.3%) showed target lesion progression. Bone metastasis was an independent poor prognostic factor.
Conclusion
Overall, most patients demonstrated stable disease with prolonged PFS; however, prominent target lesion progression occurred in some patients. Thus, PFS may capture VEGFR-TKI efficacy better than the objective response rate.

Keyword

Adenoid cystic carcinoma; Tyrosine kinase inhibitors; Vascular endothelial growth factor receptors; Axitinib; Nintedanib

Figure

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  Fig. 1. Waterfall plot of the best overall response of the 66 patients with evaluable disease, with overall best responses broken down by the administration of either vascular endothelial growth factor receptor tyrosine kinase inhibitor (axitinib [n=53] or nintedanib [n=13]).

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  Fig. 2. Spider plot of the changes in tumor size over time for each patient, starting from the initiation of vascular endothelial growth factor receptor tyrosine kinase inhibitor treatment.

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  Fig. 3. Swimmer plot illustrating the duration of vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI) treatment and progression-free survival (PFS) for each patient. Each horizontal line represents an individual patient, with the length of the line indicating the duration of VEGFR-TKI treatment. PFS events are denoted by vertical lines, providing insight into the timing of disease progression or treatment discontinuation for each patient.

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  Fig. 4. Kaplan-Meier curves depicting progression-free survival (A) and overall survival (B) for the entire patient population. Progression-free survival and overall survival were analyzed across the entire cohort, resulting in a median progression-free survival of 12.4 months (95% confidence interval [CI], 10.0 to 14.8 months) and a median overall survival of 18.1 months (95% CI, 12.7 to 23.5 months).

Reference

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