Salivary duct carcinoma (SDC) is a rare cancer representing less than 10% of all salivary gland malignancies.1,2 It is an aggressive tumour, with many patients succumbing to disseminated disease.3 Given its rarity, no standard treatment exists for metastatic SDC.
Androgen receptors (ARs) are overexpressed in most SDCs, and reports have shown some activity with anti–androgen therapy using bicalutamide with or without goserelin.4 Abiraterone, by inhibiting adrenal and testicular androgen synthesis through CYP17, has recently shown significant efficacy in castration-resistant prostate cancer,5,6 but reports of its use in SDC have not been published.
This report describes what seems to be the first published clinical and radiologic response to abiraterone in a patient with metastatic SDC refractory to bicalutamide and goserelin.
WangYLZhuYXChenTZ. Clinicopathologic study of 1176 salivary gland tumors in a Chinese population: experience of one cancer center 1997–2007. Acta Otolaryngol2012;132:879–886.
GuzzoMDi PalmaSDGrandiCMolinariR. Salivary duct carcinoma: clinical characteristics and treatment strategies. Head Neck1997;19:126–133.
JaspersHCJVerbistBMSchoffelenR. Androgen receptor-positive salivary duct carcinoma: a disease entity with promising new treatment options. J Clin Oncol2011;29:e473–476.
HowladerNNooneAMKrapchoM eds. SEER Cancer Statistics Review 1975–2011National Cancer Institute. Bethesda, MD. Available at: http://seer.cancer.gov/csr/1975_2011/ based on November 2013 SEER data submission posted to the SEER web site April 2014. Accessed February 6 2015.
LocatiLDPerroneFLosaM. Treatment relevant target immunophenotyping of 139 salivary gland carcinomas (SGCs). Oral Oncol2009;45:986–990.
FanCYWangJBarnesEL. Expression of androgen receptor and prostatic specific markers in salivary duct carcinoma: an immunohistochemical analysis of 13 cases and review of the literature. Am J Surg Pathol2000;24:579–586.
KapadiaSBBarnesL. Expression of androgen receptor, gross cystic disease fluid protein, and CD44 in salivary duct carcinoma. Mod Pathol1998;11:1033–1038.
KrishnamurthyJKrishnamurtyDMBakerJJ. Salivary duct carcinoma responding to trastuzumab-based therapy: case report and review of the literature. Head Neck2013;35:E372–375.
WilliamsMDRobertsDB. Genetic and expression analysis of HER2 and EGFR genes in salivary duct carcinoma: empirical and therapeutic significance. Clin Cancer Res2010;16:2266–2274.
NardiVSadowPMJuricD. Detection of novel actionable genetic changes in salivary duct carcinoma helps direct patient treatment. Clin Cancer Res2013;19:480–490.
LocatiLDQuattronePBossiP. A complete remission with androgen-deprivation therapy in a recurrent androgen receptor-expressing adenocarcinoma of the parotid gland. Ann Oncol2003;14:1327–1328.
SoperMSIganejSThompsonLD. Definitive treatment of androgen receptor-positive salivary duct carcinoma with androgen deprivation therapy and external beam radiotherapy. Head Neck2014;36:E4–7.
MontgomeryRBMostaghelEAVessellaR. Maintenance of intratumoral androgens in metastatic prostate cancer: a mechanism for castration-resistant tumor growth. Cancer Res2008;68:4447–4454.