AUTHOR=Viscuse Paul V. , Price Katharine A. , Garcia Joaquin J. , Schembri-Wismayer David J. , Chintakuntlawar Ashish V.
TITLE=First Line Androgen Deprivation Therapy vs. Chemotherapy for Patients With Androgen Receptor Positive Recurrent or Metastatic Salivary Gland Carcinoma—A Retrospective Study
JOURNAL=Frontiers in Oncology
VOLUME=9
YEAR=2019
URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2019.00701
DOI=10.3389/fonc.2019.00701
ISSN=2234-943X
ABSTRACT=Objectives: There is a lack of effective therapy for recurrent or metastatic salivary gland carcinoma. Androgen deprivation therapy has demonstrated efficacy in cases of salivary duct carcinoma (SDC) and high-grade adenocarcinoma not otherwise specified (NOS) that express androgen receptor.
Materials and Methods: We conducted a single institution retrospective cohort study examining patients treated for recurrent/metastatic SDC or high-grade adenocarcinoma NOS of the salivary gland. Survival analyses were performed to assess for efficacy of first-line androgen deprivation therapy (ADT) vs. first-line conventional cytotoxic chemotherapy. Efficacy of salvage ADT was also assessed.
Results: Fifty-eight patients were reviewed. Thirty-five patients had recurrent/metastatic disease of which 28 had SDC (80%) and 7 had high-grade adenocarcinoma NOS (20%). Median overall survival for first-line ADT was 25 months compared to 25 months for first-line chemotherapy [RR 0.54 (0.23–1.28, p = 0.16)]. Patients treated with first-line ADT had a response rate of 45% (9/20) and patients treated with first-line chemotherapy had a response rate of 14% (2/14). Six patients received salvage ADT with 1 patient demonstrating complete response and 3 with stable disease as best response (clinical benefit rate 67%).
Conclusion: Overall survival for first line ADT and first line cytotoxic chemotherapy was comparable but response rates to first-line ADT were higher than those with first-line chemotherapy. Salvage ADT is active in recurrent/metastatic salivary gland carcinoma.