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Published on: March 6, 2018
Abiraterone in metastatic salivary duct carcinoma
Damien Urban1, Danny Rischin1, Christopher Angel1
1From the Departments of Medical Oncology, Pathology, and Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Australia.
Abstract:
Salivary duct carcinoma (SDC) is a rare, aggressive salivary gland malignancy with limited evidence guiding standard treatment. SDC is known to overexpress the androgen receptor, with only a handful of cases reporting responses to androgen blockade. This report presents a case of SDC responding to multiple lines of androgen blockade, including a rapid response to abiraterone, a CYP17 inhibitor effective in prostate cancer. This case represents the first published report of SDC responding to abiraterone and illustrates that androgen receptor expressing SDC may be treated with multiple lines of androgen blockade, including newer agents such as abiraterone. This case suggests that SDC may continue to be androgen-dependent after progression on androgen deprivation, which is analogous to prostate cancer.
Insights
Salivary duct carcinoma (SDC), a rare cancer, showed response to multiple androgen blockade treatments. This includes a rapid positive reaction to abiraterone, suggesting SDC can remain androgen-dependent.
Area of Science:
- Oncology
- Endocrinology
- Molecular Biology
Background:
- Salivary duct carcinoma (SDC) is a rare and aggressive salivary gland cancer.
- Limited evidence exists for standard treatment protocols for SDC.
- SDC frequently overexpresses the androgen receptor (AR).
Observation:
- A case of SDC demonstrated significant response to multiple lines of androgen blockade therapy.
- The patient experienced a rapid and positive response to abiraterone, a CYP17 inhibitor.
- This marks the first reported instance of SDC responding to abiraterone treatment.
Findings:
- Androgen receptor-expressing SDC can be effectively treated with sequential androgen blockade.
- Abiraterone acetate demonstrated efficacy in a patient with SDC.
- The study highlights the potential for continued androgen dependency in SDC even after progression on prior androgen deprivation therapies.
Implications:
- This case suggests that abiraterone and other novel androgen-targeting agents may be viable treatment options for SDC.
- SDC may share similar therapeutic vulnerabilities with prostate cancer regarding androgen dependency.
- Further research into AR-targeted therapies for SDC is warranted.
