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=Volume 9 - 2019

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 and high-grade adenocarcinoma not otherwise specified that express androgen receptor.
Materials and Methods: We conducted a single institution retrospective cohort study examining patients treated for recurrent/metastatic salivary duct carcinoma or high-grade adenocarcinoma not otherwise specified of the salivary gland.  Survival analyses were performed to assess for efficacy of first-line androgen deprivation therapy versus first-line conventional cytotoxic chemotherapy.  Efficacy of salvage androgen deprivation therapy was also assessed.
Results: Fifty-eight patients were reviewed.  Thirty-five patients had recurrent/metastatic disease of which 28 had salivary duct carcinoma (80%) and 7 had high-grade adenocarcinoma not otherwise specified (20%).  Median overall survival for first-line androgen deprivation therapy 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 androgen deprivation therapy 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 androgen deprivation therapy with 1 patient demonstrating complete response and 3 with stable disease as best response (clinical benefit rate 67%).  
Conclusion: Overall survival for first line androgen deprivation therapy and first line cytotoxic chemotherapy was comparable but response rates to first-line androgen deprivation therapy were higher than those with first-line chemotherapy.  Salvage androgen deprivation therapy is active in recurrent/metastatic salivary gland carcinoma.