(Updated November 2018)
ACCRF has compiled a list of clinical trials for ACC patients with progressive disease to consider. This website is updated periodically, but may not list all the pertinent and available trials. Patients may search on their own for recruiting ACC clinical trials on the ClinicalTrials.gov website.
The clinical trials are broken down into four categories.
- The first table lists studies that are recruiting any and all ACC patients (usually phase II clinical trials).
- The second table lists studies appropriate for ACC patients whose tumors have been profiled and found to have activating alterations in NOTCH genes (either phase I or II clinical trials).
- The third table lists phase I studies of drugs that target molecules involved in the progression of most or all cases of ACC (such as MYB, MYBL1, FGFR and MDM2).
- The fourth and final table includes clinical trials that incorporate tumor profiling prior to selecting a drug (“basket studies”).
In all cases, patients should consult with their physicians to discuss the appropriate course of action.
Not all clinical trials have similarly strong scientific rationales for why the drugs should be effective in ACC. The most promising studies will involve drugs that (1) target the known mechanisms of action that drive ACC progression, (2) demonstrate activity in preclinical models of ACC, and (3) have reports of clinical benefit in an ACC patient from a case study or Phase I clinical trial. To assist patients in appraising each clinical trial, we indicate whether the evidence supporting the scientific rationale is strong, solid or fair. This assessment is based on the underlying scientific rationale, and does not mean that a particular trial is better or worse for any given patient, and should be considered along with his or her physician.
The table below lists clinical trials that currently are recruiting ACC patients in particular or salivary gland cancer patients. Unless otherwise noted, these studies are for only ACC patients with recurrent or metastatic disease. Links are provided to descriptions of the drugs as well as the www.ClinicalTrials.gov summary of each study.
Clinical Trials for All ACC Patients
Compound Targets Sponsor Locations Scientific Rationale Info Link Contact MYB vaccine and Tislelizumab Vaccine & PD-1 Immunotherapy Peter MacCallum Cancer Centre Melbourne, Australia Strong View Jayesh Desai
+61 38559 7810
Cabozantinib C-MET, VEGFR, AXL and RET Radboud University Nijmegen, Netherlands Solid View +31243618800
Carla ML van Herpen, MD, PhD Carla.vanHerpen@radboudumc.nl
Wim van Boxtel, MD Wim.vanBoxtel@radboudumc.nl
Pembrolizumab and Docetaxel PD-1 Immunotherapy University of Chicago Chicago, IL, USA Solid View Tanguy Y. Seiwert, MD
Nivolumab and Ipilimumab PD-1
Northwestern University Chicago, IL, USA Solid View Maria Matsangou, MD
Chidamide HDAC Chinese Academy of Medical Sciences Beijing, China Solid View Mei Dong
Chidamide and Cisplatin HDAC Fudan University Shanghai, China Solid View Kai Xue, MD
Apatinib and Proton Radiation (for inoperable or residual ACC) VEGFR Shanghai Proton and Heavy Ion Center Shanghai, China Strong View Lin Kong, MD firstname.lastname@example.org
Jiyi Hu, MD email@example.com
A significant subset of ACC tumors (perhaps 15-25%) have alterations in the NOTCH pathway (primarily in the NOTCH1 gene). These tumors appear to behave more aggressively. Patients for whom tumor profiling has identified a NOTCH pathway alteration may wish to discuss the following studies with their physicians:
Clinical Trials for ACC Patients with Activating NOTCH Alterations
Compound Targets Sponsor Locations Scientific Rationale Info Link Contact AL101 NOTCH Ayala Pharmaceuticals Houston, TX, New York, NY, Tampa, FL and Seattle, WA, USA Strong View Andrea Vergara-Silva, MD
Generally, patients prefer Phase II clinical trials to Phase I clinical trials because the toxicity of drugs in Phase II studies is well understood, the dosages are at potentially-therapeutic levels, and the drugs are hypothesized to be particularly effective in the specific tumor type. In addition, Phase II studies may have less stringent eligibility criteria, more plentiful slots and a higher likelihood of insurance coverage. However, if a patient is unable or unwilling to travel to a Phase II study, there are Phase I studies that offer ACC patients access to promising drugs closer to home. In addition, the scientific rationale for the drug’s effectiveness in ACC may be greater in some Phase I studies than in some Phase II studies.
The table below provides a list of selected Phase I clinical trials of drugs that inhibit molecular targets suspected of contributing to tumor growth in most ACC patients.
Selected Phase I Clinical Trials
Compound Targets Sponsor Location Scientific Rationale Info Link Contact APG-115 MDM2 Ascentage Grand Rapids, MI
San Antonio, TX
Solid View Yifan Zhai, MD, PhD
DS-3032b MDM2 Daiichi Sankyo Multiple locations in USA Solid View View Info Link for details on each site GSK3326595 PRMT5 GSK Multiple locations in USA Fair View View Info Link for details on each site
Historically, clinical trials involved only one or two treatments. Some newer trials are incorporating tumor profiling to direct patients to many more potential treatments within the same study. These “basket trials” try to match targeted drugs to genomic alterations in each patient’s particular tumor. Some of these trials profile the patient’s tumor as party of the study (NCI-MATCH) while others will suggest treatment decisions based on existing tumor profiling reports (ASCO TAPUR). The clinical trials listed below are not specifically for ACC patients, but may be worth considering in consultation with a knowledgeable physician.
“Basket” Clinical Trials Incorporating Tumor Profiling
Compound Targets Sponsor Locations Scientific Rationale Info Link Contact NCI-MATCH Multiple targets National Cancer Institute Over 1,000 locations in USA Solid View View Info Link for details on each site NCI-DART
(Nivolumab with Ipilimumab
for NCI-MATCH patients with rare tumors without targetable alterations)
Multiple targets National Cancer Institute Over 600 locations in USA Solid View View Info Link for details on each site ASCO TAPUR Multiple targets American Society of Clinical Oncology Over 20 locations in USA Solid View Pam Mangat, MS
Drug Therapies for Salivary Gland Cancers Based on Testing of Genes
(for salivary gland cancer patients, including ACC; only Canadian patients are eligible)
Multiple targets University Health Network, Toronto Toronto, Ontario, Canada Solid View Aaron Hanson, MD
Download Selected Clinical Trials – Currently Open (Updated January 2019)