Treatment response to eribulin and anlotinib in lung metastases from rare perianal adenoid cystic carcinoma: a case report

Abstract

Adenoid cystic carcinoma (ACC) is a rare salivary glands tumor and often displays aggressive behavior with frequent relapse and metastasis. The terminal ACC lacks standard treatment guidelines and is always accompanied by poor prognosis. Here, we report a case of rare perianal ACC who received resection and palliative adjuvant radiation. Five years later, PET-computed tomography (CT) showed perianal recurrence and multiple pulmonary metastases. Combined chemotherapy with doxorubicin, carboplatin and cyclophosphamide was applied for two cycles but ineffective. Further next-generation sequencing analysis of perianal tissue demonstrated the v-myb avian myelobastosis viral oncogene homolog and nuclear factor I/B fusion gene and two novel BCL-6 corepressor (BCOR) mutations (p.F1106Tfs*5 and p.L1524Hfs*8). The therapy was switched to eribulin and anlotinib and has been performed for eight cycles. At recent follow-ups, MRI and CT examinations revealed the diminishing perianal and pulmonary lesions. This study presented the first case of perianal ACC with multiple pulmonary metastases and particular BCOR mutations, who presented a durable response to eribulin and anlotinib, providing a potential therapeutic option for advanced refractory ACC.

Cavernous sinus adenoid cystic carcinoma mimicking meningioma: a case study and literature analysis

“…This indicates that TP53 might be a potential therapeutic target in patients with ACC. Additionally, in one reported case, an ACC patient with a BCL-6 corepressor mutation experienced significant inhibition of his disease after combination treatment with eribulin and anlotinib ( 46 ), which provides a certain basis for the use of this combination in treating ACC and emphasizes the need to find new therapeutic targets for ACC.…”

Emerging role of MYB transcription factors in cancer drug resistance

“…Nevertheless, prolonged progression-free survival (PFS) upon axitinib treatment was observed in MYB-NFIB-positive patients [155] . Sorafenib also exhibited considerable responses and prolonged stable disease in ACC patients [156,157] . The combination of anlotinib with the tubulin binder eribulin showed an enduring response in a MYB-NFIB and BCOR (BCL6 corepressor) mutant ACC patient after chemotherapy (carboplatin, cyclophosphamide, doxorubicin) had failed [158] .…”

“…Sorafenib also exhibited considerable responses and prolonged stable disease in ACC patients [ 156 , 157 ] . The combination of anlotinib with the tubulin binder eribulin showed an enduring response in a MYB-NFIB and BCOR (BCL6 corepressor) mutant ACC patient after chemotherapy (carboplatin, cyclophosphamide, doxorubicin) had failed [ 158 ] . A phase 2 trial of anlotinib in metastatic ACC revealed activity and controllable toxicity, indicating a possible application as palliative therapy of advanced ACC [ 159 ] .…”

Adenoid Cystic Carcinoma of Larynx

“…So VEGFR signal inhibition in the tumour may be useful in suppressing the tumour growth and blood flow [29,73,74]. Anlotinib, a tyrosine kinase inhibitor against VEGFR-1,-2,-3, and Lenvatinib, a multiple kinase inhibitor against VEGFR-1,-2,-3 kinases have shown effective results as a molecular target therapy for AdCC [72, 75,76].…”