Rivoceranib has promising antitumor activity in patients with recurrent or metastatic adenoid cystic carcinoma (ACC), according to researchers. 

Rivoceranib, a VEGFR2 tyrosine kinase inhibitor (TKI), produced responses whether or not patients had received prior treatment with a VEGFR TKI. 

These results were presented at the 2022 ASCO Annual Meeting.

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Researchers evaluated rivoceranib in a phase 2 trial (ClinicalTrials.gov Identifier: NCT04119453) that enrolled 80 patients with recurrent or metastatic ACC. 

Patients received rivoceranib at 700 mg daily until disease progression or unacceptable toxicity. 

The median follow-up was 19.5 months. The primary endpoint was objective response rate (ORR) per RECIST version 1.1 criteria. The ORR was 15.1%, with 11 patients having confirmed partial responses. 

The median duration of response was 14.9 months, and the median progression-free survival was 9 months. 

In an exploratory analysis, the researchers assessed response by Choi criteria in 60 patients, 48 of whom were VEGFR TKI-naive. The ORR was 51.7% overall, 52.1% in patients who were VEGFR TKI-naïve, and 50.0% in patients who had received a prior VEGFR TKI. 

The median duration of response by Choi criteria was 14.8 months overall, 14.8 months in patients who were VEGFR TKI-naïve, and 12.2 months in patients with prior VEGFR TKI treatment.

In all, 85.0% of patients required 1 or more dose modifications, and 20.0% discontinued treatment due to an adverse event (AE).

All patients experienced at least 1 AE, and 80.0% had a grade 3 or higher AE. Common treatment-emergent AEs of any grade included hypertension, fatigue, headache, and nausea. 

Four patients had fatal AEs — epistaxis in 2 patients and acute respiratory failure in 2 patients. 

Disclosures: This research was supported by Elevar Therapeutics. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Kang H, Ahn M-J, Muzaffar J, et al. A phase 2 study of the oral vascular endothelial growth factor receptor 2 (VEGFR2) inhibitor, rivoceranib, for recurrent or metastatic (R/M) adenoid cystic carcinoma (ACC). Presented at ASCO 2022; June 3-7, 2022. Abstract 6020.