1706P - Anti-androgen therapy for the patients with recurrent and/or metastatic salivary duct carcinoma expressing androgen receptors: a retrospective study

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Anticancer agents
Head and Neck Cancers
Therapy
Biological Therapy
Presenter Yoko Yajima
Authors Y. Yajima1, S. Fujii2, T. Kobayashi1, H. Ishiki1, R. Hayashi3, M. Tahara4
  • 1Head And Neck Medical Oncology, National Cancer Center Hospital East, 2778577 - Kashiwa, Chiba/JP
  • 2Pathology, National Cancer Center Hospital East, 2778577 - Kashiwa, Chiba/JP
  • 3Head And Neck Surgery, National Cancer Center Hospital East, 2778577 - Kashiwa, Chiba/JP
  • 4Head And Neck Medical Oncology, National Cancer Center Hospital East, JP-277-8577 - Kashiwa, Chiba/JP

Abstract

Background

Salivary duct carcinoma (SDC) is one of the WHO classified histological types of salivary gland tumors (SGT) and consists of less than 10% among all the SGT. SDC is known as highly malignant with its aggressive clinical course, high rate of recurrence and metastasis and 2-3 years of median survival time. Up-front therapy is surgery, but treatment option is quite limited when it recurs and/or metastasis not being suitable for surgical resection. Androgen receptor (AR) is expressed in about 90% of SDC. Several reports suggest that AR would be a good candidate for treatment target for this entity.

Patients and methods

We conducted a retrospective analysis in patients with AR positive, recurrent and/or metastatic SDC treated anti-androgen therapy in our institution from January 1997 and April 2012. AR positivity was defined by immunohistochemistry (AR441, DAKO). Anti-androgen therapy was given as a single agent LH-RH analogue every four weeks until disease progression or intolerable adverse events. Responses to anti-androgen therapy were assessed according to RECIST.

Results

Eight patients were included. All were male. Median age was 57 years (range 40-76). Primary site was parotid gland in 7 and submandibular gland in 1. Initial clinical stage was II in 2, IVA in 5 and IVC in 1. All patients had received surgery for SDC prior to anti-androgen therapy. The patterns of relapse were locoregional recurrence in 4 and distant metastasis in all. Median number of cycles of anti-androgen therapy was 4 (range 2-10). No serious adverse event was seen. The best responses were PR in 2 and SD in 3, and median time of response duration was 4.6 months. After progression of anti-androgen therapy, all but one received chemotherapy included platinum compounds, taxanes and fluorouracil. Median overall survival time from receiving anti-androgen therapy was 22 months.

Discussion and conclusion

Anti-androgen therapy was well tolerated and demonstrated promising clinical activity for patients with recurrent and/or metastatic SDC. This might delay the start of chemotherapy and provide survival benefits, and this approach warrants further investigation.

Disclosure

All authors have declared no conflicts of interest.