Efficacy and safety of anlotinib in metastatic adenoid cystic carcinoma: a retrospective study

Background: Metastatic adenoid cystic carcinoma (ACC) is a malignant tumor lacking effective therapies. We evaluated a multitargeted tyrosine kinase inhibitor anlotinib in patients with metastatic ACC.Methods: From September 2018 to October 2020, nineteen patients with histologically confirmed metastatic ACC of any primary site were treated with anlotinib 12 mg orally per day at the two-week on/ one-week off schedule at a single institution. Disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) were analyzed. Adverse events (AEs) were recorded.Results: The DCR of anlotinib in metastatic ACC was 63.2% (12/19), including 1 partial response and 11 stable disease. After a median follow-up of 11.0 months, median PFS was 10.1 (95% CI: 6.8-14.8) months. Median OS was not reached. The most common AEs included hypertension (n=6, 32%), oral pain (n=6, 32%), hypothyroidism (n=6, 32%), hand-foot skin syndrome (n=5, 26%), proteinuria (n=5, 26%), fatigue (n=4, 21%), and anorexia (n=4, 21%). Grade 3 AEs occurred in two cases (oral pain and hand-foot skin syndrome) and could be managed.Conclusions: Anlotinib demonstrated antitumor activity and manageable toxicity in metastatic ACC patients. Thus, metastatic ACC patients could benefit from anlotinib as a palliative targeting therapy.