Name: Emiltatug ledadotin (Emi-Le) in Adenoid cystic carcinoma with solid histology or high-grade transformation: Active surveillance
Published: 2026-09-17T22:01:26-04:00

Product information and disease description Place of product in therapy Approaches to treatment Current treatment options and standard of care

Active surveillance

4 evidence topics · 4 sources

ESMO-EURACAN guideline: watch-and-wait in selected metastatic AdCC

“To date, no systemic treatment has been shown to improve OS in patients with R/M AdCC.” (opens the source at this quote in a new tab)
“In this context, active surveillance could be a rational proposal in highly selected patients (asymptomatic, low tumour burden, lung metastases and stable disease).” (opens the source at this quote in a new tab)
“Systemic treatment should be reserved for patients with progressive and/or symptomatic disease that is not otherwise manageable.” (opens the source at this quote in a new tab)
“In case of only lung metastases without local recurrence, a watch-and-wait strategy is recommended until complaints or rapid growth (local treatment of lung metastases could be considered in selected cases) [III, B].” (opens the source at this quote in a new tab)
“In case of liver and/or bone involvement, there is a lower threshold to start (often more aggressive) systemic treatment [IV, C].” (opens the source at this quote in a new tab)

ASCO guideline: criteria for initiating systemic therapy

Recommendation 6.3 criterion	Quoted text
Stem	“Patients may be considered for initiation systemic therapy in the following circumstances:”
Criterion 1	“metastatic deposits are symptomatic and not amenable to palliative local therapy,”
Criterion 2	“growth has the potential to compromise organ function, or”
Criterion 3	“lesions have grown more than 20% in the preceding 6 months.”

French REFCOR recommendations: active surveillance of polymetastatic ACC

“At the metastatic stage, progression is often slow. In case of oligometastatic ACC, local treatment should be discussed. The most often indolent nature of polymetastatic ACC can allow management by active surveillance.” (opens the source at this quote in a new tab)

Variable natural history of metastatic ACC

“Once metastatic, the natural history can vary; some patients with indolent cancer remain asymptomatic for long periods, whereas others have rapidly progressive disease.” (opens the source at this quote in a new tab)