Phase II study of cisplatin and imatinib in advanced salivary adenoid cystic carcinoma

Br J Oral Maxillofac Surg. 2011 Oct;49(7):510-5. doi: 10.1016/j.bjoms.2010.09.013. Epub 2010 Nov 10.

Abstract

Patients with adenoid cystic carcinoma of the salivary glands show over-expression of KIT in a high proportion of cases. Options for systemic treatment are limited in locally advanced and metastatic disease. We explored the efficacy of imatinib and cisplatin combined in this group of patients. A Gehan's two-stage, phase II trial was conducted on 28 patients. Those with progressive, locally advanced, and metastatic disease with an over-expression of KIT were treated with single agent imatinib 800 mg daily for two months, followed by a combination of imatinib 400mg daily and cisplatin 80 mg/m(2) at four-weekly intervals for six cycles. This was followed by maintenance single agent imatinib 400mg daily until the disease progressed. Response was monitored using fluorodeoxyglucose positron emission tomography (FDG-PET) and morphological imaging using computed tomography, magnetic resonance, and chest radiographs (CT/MRI/CXR). Morphological imaging showed partial response in three of 28 patients, and five patients showed a response on FDG-PET. In addition, 19 patients had useful stabilisation of disease. The median time to progression and overall survival was 15 months (range 1-43) and 35 months (range 1-75), respectively. The combination of imatinib and cisplatin was reasonably well tolerated. This combination may provide stabilisation in locally advanced and metastatic adenoid cystic carcinoma of the salivary glands.

Publication types

  • Clinical Trial, Phase II
  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Benzamides
  • Carcinoma, Adenoid Cystic / drug therapy*
  • Carcinoma, Adenoid Cystic / secondary
  • Cisplatin / administration & dosage*
  • Disease Progression
  • Female
  • Fluorodeoxyglucose F18
  • Follow-Up Studies
  • Humans
  • Imatinib Mesylate
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / secondary
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Staging
  • Piperazines / administration & dosage*
  • Positron-Emission Tomography
  • Protein-Tyrosine Kinases / antagonists & inhibitors*
  • Proto-Oncogene Proteins c-kit / analysis
  • Pyrimidines / administration & dosage*
  • Radiography, Thoracic
  • Radiopharmaceuticals
  • Remission Induction
  • Salivary Gland Neoplasms / drug therapy*
  • Survival Rate
  • Tomography, X-Ray Computed
  • Young Adult

Substances

  • Antineoplastic Agents
  • Benzamides
  • Piperazines
  • Pyrimidines
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Imatinib Mesylate
  • Protein-Tyrosine Kinases
  • Proto-Oncogene Proteins c-kit
  • Cisplatin