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

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

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          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. Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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