Response to PD-1 Immunotherapy in Metastatic Spiradenocarcinoma

Wu, Clinton; Chow, Melissa; Temby, Michelle; McCalmont, Timothy H.; Daud, Adil

doi:10.1200/po.20.00285

Cited by 2 publications

(4 citation statements)

References 18 publications

(15 reference statements)

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“…Recent case reports have evaluated the role of immunotherapy with PD-1 inhibitors in treatment of metastatic spiradenocarcinoma, with one case showing initial improvement but progression after 10 months and another showing a good response to immunotherapy. The authors suggest PD-L1 immunohistochemical analysis [6,29]. Further investigations are required regarding the role of adjuvant therapies in spiradenocarcinoma.…”

Section: Discussionmentioning

confidence: 98%

Spiradenocarcinoma: SEER Study of Epidemiology, Survival, and Treatment Options

Martineau

Walz

Scampa

et al. 2023

JCM

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(1) Background: Spiradenocarcinoma is an extremely rare malignant adnexal tumor and there are only few studies on survival outcomes. Our aim was to perform an analysis of the demographic and pathological characteristics, treatment patterns, and survival outcomes of patients affected by spiradenocarcinoma. (2) Methods: The Surveillance, Epidemiology, and End Results program database of the National Cancer Institute was searched for all cases of spiradenocarcinoma diagnosed between 2000 and 2019. This database is considered representative of the US population. Demographic, pathological, and treatment variables were retrieved. Overall and disease-specific survival were computed according to the different variables. (3) Results: 90 cases of spiradenocarcinoma (47 females, 43 males) were identified. Mean age at diagnosis was 62.8 years. Regional and distant disease at diagnosis were rare, occurring in 2.2% and 3.3% of cases, respectively. Surgery alone was the most frequent treatment (87.8%), followed by a combination of surgery and radiotherapy (3.3%) and radiation therapy only (1.1%). Five-year overall survival was 76.2% and five-year disease-specific survival was 95.7%. (4) Conclusions: Spiradenocarcinoma equally affects males and females. Regional and distant invasion rates are low. Disease-specific mortality is low and is probably overestimated in the literature. Surgical excision remains the main form of treatment.

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Section: Discussionmentioning

confidence: 98%

Spiradenocarcinoma: SEER Study of Epidemiology, Survival, and Treatment Options

Martineau

Walz

Scampa

et al. 2023

JCM

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“…To our knowledge, this is the first paper to report on the use of immunotherapy for the management of metastatic DEA. On review of the published literature, 5 case reports in the last decade have presented favourable outcomes for immunotherapy used in other subtypes of eccrine carcinoma: two for eccrine porocarcinoma [14, 15], two for eccrine spiradenocarcinoma [7, 16], and one for eccrine carcinoma not otherwise specified [13] (Table 1). Of these, the report by Singh et al shared many similarities with our own case: the authors described an elderly male with eccrine porocarcinoma of the anterior scalp, initially managed with surgical excision and adjuvant radiotherapy, later complicated by multiple distant metastases.…”

Section: Discussionmentioning

confidence: 99%

“…For metastatic eccrine carcinoma, conventional chemotherapy has been shown to be of limited benefit [7]. Data for the use of other systemic therapies, including targeted agents such as cetuximab, are limited to single-case reports only [8].…”

Section: Introductionmentioning

confidence: 99%

“…The role of immunotherapy for metastatic non-melanoma skin cancer (NMSC) is an area of active research. Only a handful of case reports of immunotherapy in the setting of eccrine carcinomas are available, the majority for metastatic eccrine porocarcinoma [7,8,[13][14][15][16]. The use of immunotherapy for metastatic DEA has not previously been published.…”

Section: Introductionmentioning

confidence: 99%

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Metastatic Ductal Eccrine Adenocarcinoma with Excellent Response to Immunotherapy

Fadhil,

Lochhead,

Trinh

et al. 2023

Case Rep Oncol

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Eccrine carcinoma, a subtype of which is ductal eccrine adenocarcinoma (DEA), is a rare cutaneous malignancy. For metastatic eccrine carcinoma, there are very limited data to guide treatment. Conventional chemotherapy is of limited benefit and there is only a small body of evidence for the use of immunotherapy in non-DEA eccrine carcinomas. We report the first case of metastatic DEA treated with a multimodality approach including surgery, radiotherapy, and immunotherapy, with an excellent prolonged response to pembrolizumab, and provide a review of the literature on pathological and management aspects for this rare tumour subtype. A 60-year-old male with a history of pT1N0M0 left scalp DEA, managed 2 years prior with excision and adjuvant radiotherapy, represented with a symptomatic right pontine metastasis. Imaging demonstrated intracranial, pulmonary, and hilar disease; biopsy of the cranial and lung lesions showed metastatic adenocarcinoma, morphologically similar to the previously resected scalp DEA. The patient was treated with stereotactic resections of his pontine metastases and adjuvant cranial radiotherapy, then commenced on immunotherapy with pembrolizumab. The patient has completed 21 months of pembrolizumab with a significant radiological response of the pulmonary and hilar disease and nil evidence of intracranial recurrence or further metastases. In this case report, we provide the first evidence of efficacy of immunotherapy in metastatic DEA, demonstrating an excellent and prolonged response of metastatic DEA to pembrolizumab. Further research is required to better establish the role of immunotherapy within the management protocol for this uncommon but aggressive tumour subtype.

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Response to PD-1 Immunotherapy in Metastatic Spiradenocarcinoma

Cited by 2 publications

References 18 publications

Spiradenocarcinoma: SEER Study of Epidemiology, Survival, and Treatment Options

Spiradenocarcinoma: SEER Study of Epidemiology, Survival, and Treatment Options

Metastatic Ductal Eccrine Adenocarcinoma with Excellent Response to Immunotherapy

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