PURPOSE The androgen receptor (AR) is expressed (+) in a subset of salivary gland cancers (SGCs). This phase II trial evaluated the efficacy of the antiandrogen enzalutamide in AR+ SGC. METHODS Patients with locally advanced/unresectable or metastatic AR+ SGCs were enrolled. Enzalutamide (160 mg) was given orally once daily. The primary end point was the best overall response rate per RECIST v1.1 within eight cycles. Confirmed responses in ≥ 5 of 41 patients would be considered promising. Secondary end points were progression-free survival, overall survival, and safety. RESULTS Forty-six patients were enrolled; 30 (65.2%) received prior systemic therapy, including 13 (28.3%) with AR-targeted drugs. Of seven (15.2%) partial responses (PRs), only two (4.3%) were confirmed per protocol and counted toward the primary end point. Twenty-four patients (52.2%) had stable disease; 15 (32.6%) had progression of disease as best response. Twenty-six patients (56.5%) experienced tumor regression in target lesions; 18 (39.1%) had partial response/stable disease ≥ 6 months. Tumor regressions were observed in female patients (5 of 6 [83.3%]) and those who received prior AR– (6 of 13 [46.2%]) or human epidermal growth factor receptor 2–targeted therapies (5 of 8 [62.5%]). Three patients remained on treatment at data cutoff (duration, 32.2-49.8 months). The median progression-free survival was 5.6 months (95% CI, 3.7 to 7.5); the median overall survival was 17.0 months (95% CI, 11.8 to 30.0). The most common adverse events were fatigue, hypertension, hot flashes, and weight loss. Total and free testosterone levels increased by a mean of 61.2% and 48.8%, respectively, after enzalutamide. CONCLUSION Enzalutamide demonstrated limited activity in AR+ SGC, failing to meet protocol-defined success in part because of a lack of response durability. Strategies to enhance the efficacy of antiandrogen therapy are needed.
To understand misinformation surrounding infertility and the COVID19 vaccine on Twitter by analyzing the prevalence and content of this misinformation. DESIGN:This study involves content analysis of tweets from a public dataset to identify the etiology of misinformation. MATERIALS & METHODS:Tweets included were from key points in the COVID19 vaccine discourse (July 2021 and December 2021) and contained at least one word related to COVID19 vaccination and one word related to fertility. Relevant tweets were analyzed for factuality. Descriptive statistics on followers, verification status, and engagement were obtained. Differences between the factual and misinformation groups were examined using ANOVA or Chi-square tests. Rates of factual vs misinformation tweets were compared to US COVID19 case counts and the most common hashtags and words were determined. Sentiment analysis was used to determine if tweets were positive, neutral, or negative. RESULTS:Misinformation tweets rose from 29.9% in July 2021 to 45.1% in December 2021. The proportion of misinformation in July 2021 fell as daily COVID19 cases rose (r=-0.50, p= 0.01), while relevant tweets mirrored cases (r=0.53, p< 0.001). Accounts sharing factual information had more followers (p<0.001) and verified users were more likely to share factual tweets (p=<0.001). Factual and misinformation tweets had similar engagement. Common hashtags in factual tweets included #getvaccinated and #vaccineswork, compared to #vaccinesideeffects and #vaccineskillingunbornbabies in misinformation tweets. Sentiment analysis found factual tweets were more positive and misinformation tweets more negative (p<0.001).CONCLUSION: Misinformation about the COVID19 vaccine and infertility is a threat to vaccine uptake in patients desiring future fertility. Understanding the content, sentiment, and reach of tweets is vital to combat misinformation.
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