Would you offer adjuvant TKI to patients with locally recurrent multifocal adenoid cystic carcinoma?

I would not give a TKI in the adjuvant setting following a local recurrence that was resected. The only data that we have with these agents are in the setting of metastatic disease. The likelihood of recurrence, I believe, would be quite high once the agents are stopped, as we do not know how long of a period to treat. Finally, the toxicity profiles related to TKI therapy can be quite severe, leading to poor compliance and dosage reductions in many patients, which could ultimately affect outcome...