Salivary ductal adenocarcinoma with complete response to androgen blockade
Accepted for publication July 17, 2018
Correspondence
Luke J Meininger, MD; luke.j.meininger.mil@mail.mil
Disclosures The authors report no disclosures/conflicts of interest.
Citation JCSO 2018;16(4):e200-e201
©2018 Frontline Medical Communications
doi https://doi.org/10.12788/jcso.0419
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Discussion
The oncology care team clearly defined the goal of care for this patient as palliative and conveyed as such to the patient. The team considered the risks and side effects of cytotoxic chemotherapy agents to be contrary to the patient’s stated primary goal of independence. We selected the combined androgen blockade because it has a low toxicity rate and thus met the primary goals of therapy.
The European Organization for Research and Treatment of Cancer is presently conducting a trial in which cytotoxic chemotherapy is being compared with ADT in AR-positive salivary duct tumors. Findings from a recent prospective, phase-2 trial conducted in Japan suggested that combined AR blockade has similar efficacy and less toxicity than conventional cytotoxic chemotherapy for recurrent and/or metastatic and unresectable locally advanced AR-positive salivary gland carcinoma.7 As more data become available from other studies, it is possible that practice guidelines will be revised to recommend this treatment approach for these cancers.
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