A new Investigator initiated Phase II trial combining Cellestia’s CB-103 and Lenvatinib for the treatment of metastatic Adenoid Cystic Carcinoma (ACC) is starting at the Dana–Farber Cancer Institute. CB-103 is a small molecule transcriptional pan-NOTCH inhibitor with a novel mechanism of action. A Phase I clinical trial has shown promising safety and tolerability, proof of biological activity, and signs of efficacy. A new investigator initiated trial (IIT) is starting at the Dana-Farber Cancer Institute, Department of Medical Oncology, Center for Head & Neck Oncology CB-103, in combination with Lenvatinib (a Vascular Endothelial Growth Factor Receptor (VEGFR) inhibitor, widely used in this indication) will be tested, given the synergies between the two pathways to improve the outcome of patients with metastatic Adenoid Cystic Carcinoma. The IIT trial at Dana-Farber Cancer Institute is now open for patient recruitment.