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ACCRF R esearch Update
April 2020

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covidCOVID-19 Impact on ACC Research

Over the past few months, Coronavirus Disease 2019 (COVID-19) has developed into a global pandemic, leading to widespread illness, deaths and disruptions to normal activities. The entire community of ACC patients, physicians and researchers has been impacted and, sadly, will continue to be amid travel restrictions, social distancing and the need to preserve hospital capacity for COVID-19 cases.  

Fortunately, our community is pressing forward in various ways to ensure that ACC patients have better outcomes in the future:
  • ACCRF grants - Funded researchers continue to pursue basic, translational and clinical research projects, some with only minor delays. We know of only two small projects that have been paused.
  • Preclinical screening - ACCRF studies of new drugs in preclinical models have proceeded on schedule without any delays.
  • Clinical trial accrual - Most clinical trials continue to screen and enroll ACC patients with recurrent/metastatic disease. However, there may be delays for out-of-town patients (due to travel restrictions), especially if the drugs are infused and require hospital visits (Avelumab, AL101 and Pembrolizumab).
  • Telemedicine - Even in COVID-19 hotspots, patients are typically able to maintain their ongoing monitoring and enrollment in clinical trials through remote consultations by video or phone. The increased reliance on telemedicine most likely will persist even after the pandemic subsides, facilitating research.
ACC patients should take comfort that, despite the enormous focus on COVID-19, physicians and researchers remain focused on treating and finding better therapies for them.
For patient-oriented information on COVID-19, please visit these websites of the  National Cancer Institute and the  Food and Drug Administration.

trialsClinical Trials
Many hospitals with  ACC clinical trials continue to enroll and monitor patients in the face of COVID-19 disruptions. However, ACC patients with recurrent/metastatic disease who typically enroll in such studies should keep these points in mind:
  • Some sites have temporarily stopped accruing all new patients due to limits on hospital visits or procedures that are necessary at enrollment.  In some countries where COVID-19 testing is widely available, patients may need a negative test before being able to enter a hospital.
  • Travel limitations may preclude enrollment of out-of-town patients. Infused drugs typically require weekly hospital visits that may not be possible or advisable. Typically, oral drugs may be shipped to out-of-town patients.
  • The side effects of some immunotherapy drugs mimic the symptoms of COVID-19, complicating the care of such patients. Accordingly, some immunotherapy clinical trials may not be appropriate for some patients at the moment.
The global situation is in flux and conditions will continue to change at each cancer center. ACC patients considering trials must maintain close communications with their physicians to keep abreast of changing conditions. The same clinical trial may have different statuses at different sites, so it is important to learn site-specific details on enrollment.
ACCRF maintains a list of  Current Studies that may be appropriate for recurrent/metastatic ACC patients upon consultation with their physicians. Here is a list of recent changes:
  • Rivoceranib (Apatinib) - Recently opened in Seoul, Korea and in Denver and Boston, USA. Ongoing in San Francisco, USA.
  • ATRA - Reopened at a higher dose in Boston, USA.
  • CV8102 - Newly listed study in Germany for patients with unresectable, locally-advanced ACC.
  • MYB DNA vaccine - Temporarily paused in Melbourne, Australia. 
We recently reorganized the lists to include a table for ACC patients with unresectable, locally-advanced disease (a fairly small subset of patients in clinical trials). Typically, these studies involve radiation or injected drugs to the inoperable primary site. The other three tables involve systemic therapy (infused and/or oral drugs) for recurrent/metastatic patients.
SABACCRF Scientific Leadership
The ACC community of patients and researchers has been incredibly fortunate to benefit from the wise counsel of the  ACCRF Scientific Advisory Board (SAB). Comprised of world leaders in oncology volunteering their expertise, the SAB has set the strategic direction for the foundation and regularly reviews the most promising research projects. Some recent changes in scientific leadership are worth noting:

Dr. Lillian Siu  stepped down from the SAB following more than eight years of service. She contributed her brilliant and forceful voice to discussions, always providing thoughtful and remarkably rapid feedback. The ACC patient community always will owe her an enormous debt of gratitude for helping steer the ship in the right direction.

Dr. Gegory Verdine  recently agreed to join the SAB. Beyond his academic credentials as a Professor of Chemistry at Harvard University, he has started several biotechnology firms, developed new therapeutic approaches and shepherded novel drugs through to FDA approval.

Dr. Sara Buhrlage recently agreed to join the SAB. An Assistant Professor in Dana-Farber's Cancer Biology Department and the Harvard Medical School's Biological Chemistry and Molecular Pharmacology Department, she will provide invaluable guidance in ACCRF's targeted drug discovery and development efforts.

Dr. Nicole Spardy Burr  was promoted to the position of ACCRF Director of Research, an acknowledgement of her thoughtful and diligent stewardship of the foundation's research projects. She joined ACCRF four years ago and has confidently managed our network of grantees and the preclinical drug screening program, while also educating and interacting with patients.

ACCRF's past successes have flowed out of the strategic vision of our scientific leadership. With the latest changes, we are poised to enjoy even more progress.
pubsRecent Publications
ACCRF grantees continue to make important findings in understanding ACC and finding new therapeutic approaches. Here  we review some scholarly articles from recent months:
  • Carla van Herpen and colleagues at Radboud University published on PSMA-ligands for imaging and therapeutics in ACC. Radiotherapeutics designed for prostate cancer appear to be applicable for many ACC patients. Two clinical trials are in preparation based on this concept.
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