Dr Patel on the BTCRC HN17-111 Trial of ADT Plus Pembrolizumab in Salivary Gland Cancer

“Our thought was to use ADT as a way of enhancing immune therapy responses in [patients with salivary gland cancer].”

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 clinical framework of the single-arm, phase 2 BTCRC HN17-111 study (NCT03942653) investigating the integration of androgen deprivation therapy (ADT) in combination with pembrolizumab (Keytruda) for the treatment of patients with advanced-stage, androgen receptor (AR)–positive salivary gland cancer.

The trial used goserelin, an FDA-approved gonadotropin-releasing hormone agonist and antagonist that has historically been implemented in the management of breast and prostate cancers, according to Patel. He noted that this trial enrolled a subset of patients with salivary gland cancer characterized by high AR expression.

Patel highlighted the biological rationale behind combining ADT with immunotherapy, explaining that inhibiting the AR may serve as a catalyst for increasing immune response. This approach is supported by emerging laboratory and clinical data suggesting that androgen deprivation can potentially enhance the effectiveness of immunotherapy in this patient population, he explained. The primary objective of the BTCRC HN17-111 trial was to evaluate whether ADT can successfully prime the immune system to improve overall therapeutic outcomes in this disease, he added.

During the time that this trial was being conducted, other data have emerged in the head and neck cancer research paradigm, Patel continued. Overall, he emphasized the importance of the availability of increasingly effective therapies for patients with salivary gland cancer that surpass the benefits seen with standard chemotherapy. The particular combination of ADT and immunotherapy is a promising therapeutic strategy for these patients, he concluded.

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.