DeCure for Adenoid cystic carcinoma

A 1979 case report described a partial remission with adriamycin in one patient with advanced metastatic adenoid cystic carcinoma, but the same report noted that no satisfactory form of therapy had been established for the disease. A 1985 retrospective study of 59 head and neck ACC patients treated mostly with surgery and radiotherapy reported actuarial survival rates of 68% at 5 years, 45% at 10 years, and 30% at 15 years. A 2009 case of primary ACC of the cervix at stage IIIB was managed successfully with concurrent chemo-radiotherapy, though the authors stated that optimal management could not be established for certain and that combined treatment appeared necessary for long-term remission. A 2014 review concluded that the effects of surgery, radiotherapy and chemotherapy on ACC are not very satisfactory, and turned attention to biological therapy and gene therapy as areas of progress. A 2023 review of lacrimal gland ACC reiterated that initial therapy consists of surgical resection followed by postoperative radiotherapy, and that late diagnosis, perineural invasion, periosteal infiltration and local recurrence are factors of poor prognosis.

A 2025 research proposal states plainly that no systemic agent has been found effective in improving long-term disease control for ACC, that standard curative management has modest activity, and that most patients recur because of perineural invasion or distant metastasis. It notes that over 60% of patients die within 10 years of diagnosis, that no FDA-approved targeted treatments exist, and that studies of new therapies are hindered by a paucity of specimens and preclinical cellular models. The proposal identifies two understudied proteins, HECTD2 and JMJD1C, as putative therapeutic targets using transcriptomic data and an AI-driven discovery engine, and outlines a one-year plan to assess whether deleting these proteins induces anti-tumor activity in ACC cell lines and organoids, map their protein interactomes, and define the signalling pathways they drive. The authors acknowledge that the role of these proteins in ACC tumorigenesis is unknown and requires thorough investigation.

What remains missing is sustained funding for rare-disease research, robust preclinical models that recapitulate ACC’s slow growth and metastatic behaviour, and clinical trial designs capable of testing targeted agents in a small, heterogeneous patient population. No stratification strategy for ACC patients has been validated, and no systemic therapy has yet improved long-term outcomes.