Androgen deprivation therapy in metastatic salivary duct carcinoma of submandibular gland – A case report

Abstract

Salivary duct carcinomas (SDCs) are aggressive rare neoplasms. Whose diagnosis and treatment are a clinical challenge to both the treating doctor as well as the pathologist. Primary surgery with or without neck dissection followed by adjuvant radiation treatment is preferred for those with localized SDCs. Even with localized disease, the 5-year survival is <30%. For metastatic disease, the treatment options are limited. Two important biomarkers identified in SDCs are androgen receptors (ARs) and human epidermal growth factor receptor 2 receptors. Androgen deprivation therapy has evolved from the treatment of prostatic malignancies and various androgen-targeted agents are already in use for prostatic cancers. This case study represents the successful treatment of a metastatic SDC of the submandibular gland with AR-targeted agents. This patient has undergone treatment with multiple lines of Androgen targeted agents which is still ongoing. The main Androgen targeted agents used in this particular patient are Abiraterone and Enzalutamde. The patient has already achieved a disease-free survival of 30 months. Further studies have to be conducted to target ARs and more agents need to be tried.