Lenvatinib in Relapsed/Metastatic Adenoid Cystic Carcinoma: Real-World Data From 17 Italian Centers

Head Neck. 2025 Jul;47(7):2040-2047. doi: 10.1002/hed.28124. Epub 2025 Mar 3.

Abstract

Background: Lenvatinib, a multi-target tyrosine kinase inhibitor (MTKI), has demonstrated activity in recurrent or metastatic (R/M) adenoid cystic carcinoma (ACC) in phase II studies.

Methods: This multicenter, retrospective study included patients with R/M ACC treated with lenvatinib. The primary endpoint was the overall response rate (ORR).

Results: Fifty-one patients were included across 17 Italian sites. Forty-six patients (90%) were evaluated for response: the ORR was 21.7%, with 10 patients achieving a partial response; 24 patients had a stable disease resulting in a disease control rate of 73.9%. At least one treatment-related adverse event (TRAE) was recorded in all patients. The most frequent TRAEs of grade > 3 were hypertension (25.5%), stomatitis (17.6%), and fatigue (15.7%); one grade 5 TRAE (bleeding) was reported. Median OS was 16.1 months (95% CI 12.2-NR) with six-month PFS at 75.7%.

Conclusion: Lenvatinib confirmed its activity in the real-world population. A higher than expected rate of grade > 3 stomatitis was reported.

Keywords: MTKI; adenoid cystic carcinoma; lenvatinib; salivary gland cancer; systemic therapy.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents* / therapeutic use
  • Carcinoma, Adenoid Cystic* / drug therapy
  • Carcinoma, Adenoid Cystic* / mortality
  • Carcinoma, Adenoid Cystic* / pathology
  • Carcinoma, Adenoid Cystic* / secondary
  • Female
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local* / drug therapy
  • Neoplasm Recurrence, Local* / mortality
  • Neoplasm Recurrence, Local* / pathology
  • Phenylurea Compounds* / adverse effects
  • Phenylurea Compounds* / therapeutic use
  • Protein Kinase Inhibitors / therapeutic use
  • Quinolines* / adverse effects
  • Quinolines* / therapeutic use
  • Retrospective Studies
  • Salivary Gland Neoplasms* / drug therapy
  • Salivary Gland Neoplasms* / mortality
  • Salivary Gland Neoplasms* / pathology
  • Treatment Outcome

Substances

  • lenvatinib
  • Quinolines
  • Phenylurea Compounds
  • Antineoplastic Agents
  • Protein Kinase Inhibitors