title: Successful treatment of c-kit-positive metastatic Adenoid Cystic Carcinoma (ACC) with a combination of curcumin plus imatinib: A case report.
abstract: Adenoid cystic carcinoma (ACC) is an aggressive malignant neoplasm of the secretory glands. Conventional chemotherapy has poor effectiveness against metastatic ACC. Thus, a novel effective therapy is needed against metastatic ACC. A majority of ACCs (up to 94%) express c-kit. Imatinib is monoclonal antibody with specific activity against c-kit but has not been found to be effective in treating patients with ACC in which c-kit is overexpressed and activated. The NF-κB and mTOR pathways have been shown that ubiquitously and concurrently activated, indicating that the inhibition of these pathways may represent a novel treatment approach for patients with ACC. Curcumin has been shown to inhibit NF-κB and NF-κB-related pathways. 43-year-old patient was diagnosed ACC from submandibular salivary gland. After complete resection of tumor adjuvant radiotherapy was initiated. Seven years later multiple lung metastases were detected and ACC was confirmed by re-biopsy. First-line chemotherapy failed. NF-κB and c-kit were overexpressed in the metastatic specimens. Therefore, we treated the patient with metastatic chemoresistant ACC with imatinib 400mg/day and intravenous curcumin 225mg/m(2) twice a week plus oral bioavailable curcumin Arantal(®) 2×84mg/day. At 24 months, we observed near complete anatomic and complete metabolic response. To our knowledge, this is the first report of a patient with a c-kit-positive ACC that is successfully treated with the combination of imatinib and curcumin in an integrative approach.
authors: Medicana International Istanbul Hospital, Department of Medical Oncology, Istanbul, Turkey. Electronic address: drdemiray@gmail.com.
authors: M
authors: M
authors: Demiray
authors: Institute for Hyperthermia Research, Partner of the Marien Hospital Herne, Hospital of the Ruhr-University Bochum, Germany. Electronic address: hssahinbas@googlemail.com.
authors: H
authors: H
authors: Sahinbas
authors: Pato.net Pathology Laboratory, Bursa, Turkey. Electronic address: dratahan@gmail.com.
authors: S
authors: S
authors: Atahan
authors: Medicana International Istanbul Hospital, Department of Nuclear Medicine, Istanbul, Turkey. Electronic address: hulyaademiray@hotmail.com.
authors: H
authors: H
authors: Demiray
authors: Medicana International Istanbul Hospital, Department of Radiology, Istanbul, Turkey. Electronic address: drdoganselcuk@yahoo.com.
authors: D
authors: D
authors: Selcuk
authors: Ali Osman Sonmez Oncology Hospital, Department of Radiation Oncology, Bursa, Turkey. Electronic address: driyildirim@hotmail.com.
authors: I
authors: I
authors: Yildirim
authors: Medipol University Medical Faculty, Department of Family Medicine, Turkish Holistic & Integrative Medicine Association, Istanbul, Turkey. Electronic address: atayoglu@gmail.com.
authors: A T
authors: AT
authors: Atayoglu
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003528:Carcinoma, Adenoid Cystic / Q000188:drug therapy* / Q000378:metabolism; D003474:Curcumin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000379:methods; D006801:Humans; D000068877:Imatinib Mesylate / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism*
chemical_list: D000970:Antineoplastic Agents; D000068877:Imatinib Mesylate; D019009:Proto-Oncogene Proteins c-kit; D003474:Curcumin
keywords: Adenoid cystic carcinoma; Arantal; Curcumin; Imatinib; Integrative medicine