Cancer Treatment Today

A report of a response  by Soper et al. is of a single patient. While androgen receptors are now recognized to be present in some salivary gland cancers, it is a a largely unexplored area clinically, but it is also a rare cancer. The 2016 ASCO presentation would be considered supportive literature for this rare disease.  A total of 157 pts with SDC were identified. Median age was 66 years, 77% were male. AR and HER2neu were positive in 100% and 44%, respectively. Median number of positive LN was 4 (range 0–97) and median LNR was 0.20. Median OS was 44 months (95% CI 30-48). Multivariable analyses identified male gender, high N-stage and high LNR as significant poor prognostic factors for OS. After median 14 months (range 1-87) 84 pts (54%) had recurrent disease: local recurrence in n = 19 (23%), regional recurrence in n = 31 (37%) and distant metastases in n = 72 (86%). Only 12 (14%) of recurrent pts had local and/or regional recurrence without distant metastases. 31 pts with recurrent SDC were treated with ADT: 4 pts had PR, 10 pts had SD and 17 pts had PD. Median PFS of all ADT treated pts was 3.8 months (range 1-25) and median OS 4 months (range 1–64). In pts with PR or SD (45%) median PFS was 11 months (range 3-25) and median OS was 29 months (range 3-64). Conclusions: More than half of the SDC pts developed recurrent disease. Male gender, high N-stage and high LNR were correlated with worse OS. In this largest series of ADT treated SDC pts, we found clinical benefit (PR + SD) in 45% of pts for a median duration of 11 months and median OS of 29 months. The authors wrote: “We recommend considering ADT treatment in recurrent SDC.”

Soper MS1, Iganej S, Thompson LD.Definitive treatment of androgen receptor-positive salivary duct carcinoma with androgen deprivation therapy and external beam radiotherapy.Head Neck. 2014 Jan;36(1):E4-7.

Elena Vagia et al, Androgen-Receptor Positive Lacrimal Sac Adenocarcinoma Demonstrating Long-Lasting Response to LHRH Analog Plus Abiraterone Treatment .Front Oncol. 2015; 5: 10.

E. Boon et al, Salivary duct carcinoma: Clinical outcomes and prognostic factors in 157 patients and results of androgen deprivation therapy in recurrent disease (n=31)—Study of the Dutch head and neck society (DHNS).J Clin Oncol 34, 2016 (suppl; abstr 6016)