Dr Patel on Future Directions for Studying ADT Plus Immunotherapy in Salivary Gland Cancer

“[For these findings] to be definitive, we need a randomized controlled trial, but [so far, these data] provide an avenue for further development of ADT in combination with immune therapy for this disease.”

Manish Patel, DO, a medical oncologist at the University of Minnesota Health and an associate professor of medicine in the Division of Hematology, Oncology and Transplantation in the Department of Medicine at the University of Minnesota Medical School, discussed the emerging clinical significance of combining hormonal and immune therapies for the treatment of patients with salivary gland cancer.

Patel detailed the efficacy and current limitations of the phase 2 BTCRC HN17-111 trial (NCT03942653) regimen of androgen deprivation therapy (ADT) plus pembrolizumab (Keytruda). He also emphasized how synergy between androgen blockade and immunotherapy could provide a much-needed treatment option for patients facing this rare malignancy.

Patel noted that although the current dataset supports the use of ADT plus pembrolizumab in this patient population, it is currently difficult to determine how it compares with other established regimens. He explained the context of the research, noting that the BTCRC HN17-111 study only included 19 patients because of the rarity of this tumor type. He said that although this small sample size makes it difficult to definitively categorize the regimen as a new standard of care, it remains a robust treatment consideration. He explained that releasing these data to the oncology community is a critical step that may assist in eventually getting the regimen approved, although he cautioned that the path forward necessitates more extensive clinical study.

Patel focused on the specific role of pembrolizumab in the trial, acknowledging that previous studies using combined androgen blockade without immunotherapy yielded similar efficacy results. He stressed that his team is committed to understanding the unique contribution of immunotherapy in this setting and plans to conduct correlative studies to identify post-treatment changes in the immune response.

Disclosures: Patel reported that the study was funded by Merck, Sharpe and Dohme and supported by TerSera Therapeutics, LLC. Patel’s disclosures unrelated to this study include receiving research funding/consultant fees from AstraZeneca and serving on the Bayer advisory board.