eligibility_summary
Inclusion: ≥18, inoperable locally advanced/metastatic, histologically confirmed salivary ACC, WHO PS 0–2, PSMA+ (68Ga-PSMA PET/CT), measurable (RECIST 1.1), adequate marrow (ANC >1500, Plt >150k, Hgb >9), liver (bilirubin <2×ULN, AST/ALT <3×ULN, <5×ULN with liver mets), kidney (eGFR >50), negative pregnancy test and contraception. Exclusion: pregnancy/breastfeeding or no contraception, brain/meningeal/heart mets, urinary obstruction/hydronephrosis, other cancer therapy, myelosuppressive/nuclear therapy <4 wks, prior 177Lu‑PSMA.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Intervention: Lutetium-177 vipivotide tetraxetan (Pluvicto), a small‑molecule PSMA-targeted radioligand (beta-emitting radiopharmaceutical). Dosing: 6 cycles every 6 weeks. Mechanism of action: The PSMA ligand binds the transmembrane enzyme PSMA (FOLH1) on PSMA-expressing cells, is internalized, and delivers 177Lu beta radiation, causing DNA double‑strand breaks and tumor cell death, including a crossfire effect to adjacent cells. Companion diagnostic/selection: 68Ga‑PSMA I&T PET/CT to confirm PSMA expression prior to therapy. Cells/pathways targeted: PSMA-positive ACC tumor cells and PSMA-expressing tumor neovasculature endothelium, pathway impact is radiation-induced DNA damage leading to apoptosis/necrosis.