Sustained response of HER2-positive metastatic salivary adenocarcinoma, not otherwise specified, treated with trastuzumab

Ghazali, Naseem; Parker, Lynette; Settle, Kathleen; Lubek, Joshua E.

doi:10.1016/j.oooo.2016.03.020

Cited by 7 publications

(5 citation statements)

References 38 publications

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“…Some phase II trials, case series, and case reports have demonstrated benefits for patients treated with combined chemotherapy and trastuzumab after metastasis. After progression, there is no standard treatment for patients with HER2-positive metastatic SDC [ 8 , 9 , 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Second-Line Treatment of HER2-Positive Salivary Gland Tumor: Ado-Trastuzumab Emtansine (T-DM1) after Progression on Trastuzumab

Correa

Matos

Segura³

et al. 2018

Case Rep Oncol

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Patients with salivary duct cancer (SDC) and HER2 overexpression could receive trastuzumab in combination with chemotherapy for metastatic disease. No standard treatment exists for patients with HER2-positive metastatic SDC after progression. We report an excellent patient response to second-line treatment with T-DM1 after progression on paclitaxel plus trastuzumab. Case Report: In June 2014, a 79-year-old male patient underwent right parotidectomy and ipsilateral radical neck dissection after the diagnosis of parotid carcinoma. Pathological staging demonstrated locally advanced disease with the involvement of 13 lymph nodes (levels I, II, III, and IV), with extracapsular extravasation. He underwent adjuvant radiotherapy ending in December 2014. A PET scan in March 2015 diagnosed recurrent and systemic disease, with bone lesions, neck lymph node involvement, and hepatic metastasis. The immunohistochemistry showed HER2 receptor overexpression (+3/+3). The patient received first-line trastuzumab plus paclitaxel beginning in April 2015. After 6 cycles, his response was confirmed by PET scan. In February 2016, he had symptoms of disease progression, and a PET scan revealed disease progression in the neck, bones, and liver. He started T-DM1 in April 2016. The neck skin lesions disappeared after 6 cycles, with low toxicity. PET scans performed every 3 months showed response in the liver and bone lesions. Conclusions: We report the case of a patient with SDC treated with T-DM1, with a very good response. Salivary carcinoma is a rare disease for which no randomized clinical trials are available. The maintenance of HER2 blockage might be important in this disease.

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Section: Discussionmentioning

confidence: 99%

Second-Line Treatment of HER2-Positive Salivary Gland Tumor: Ado-Trastuzumab Emtansine (T-DM1) after Progression on Trastuzumab

Correa

Matos

Segura³

et al. 2018

Case Rep Oncol

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“…However, information on metastasis is scarce. Interestingly, one case of AdCaNOS presented multiple metastases and the patient was maintained on chemotherapy with trastuzumab [7]. Nevertheless, reports about AdCaNOS are scarce in the literature, thus, it is imperative that the various histopathological aspects of the AdCaNOS are known, so that its diagnosis is facilitated, avoiding misdiagnosis.…”

Section: Introductionmentioning

confidence: 99%

Intraoral Pigmented Low-Grade Adenocarcinoma, Not Otherwise Specified: Case Report and Immunohistochemical Study

Santos

Altemani

Trivellato

et al. 2017

Head and Neck Pathol

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Salivary adenocarcinoma, not otherwise specified (AdCaNOS) is a rare malignant tumor with potential diagnostic challenge, which mainly affects the parotid glands; however, the minor salivary glands can also be involved by AdCaNOS. This paper reports a case of a 45-year-old Afro-descendant woman complaining of a slow-growing mass with 6 months of evolution in the left superior vestibular fornix. Microscopic examination revealed an infiltrative epithelial neoplasm composed of predominantly solid growth pattern, arranged in a lobular configuration, admixed with glandular or ductal structures. Perineural invasion was evident. The tumor cells were polygonal or oval showing focally mild nuclear pleomorphism, and eosinophilic or clear cytoplasm. Notably, some areas exhibited intracytoplasmic pigment granules mainly in non-luminal cells, as well as sebaceous-like cells, discrete hyaline material deposition and foci of infiltration of residual salivary gland parenchyma. Tumor cells were negative for PAS, mucicarmine and Alcian blue stains. By immunohistochemistry, the tumor cells were diffuse and strongly positive for pan-cytokeratin (CK) AE1/AE3, 34betaE12 CK, vimentin, p63 and S100. CK7 and EMA strongly highlighted the ductal structures. Solid areas also showed diffuse and moderate expression of CD56. Podoplanin (D2-40), GFAP and Calponin, followed by DOG-1, were focally positive; whereas CK20, α-SMA, h-Caldesmon, CD57, ERBB2/HER2 and p53 were negative. Ki-67 was < 2%. Consecutive serial tissue sections using CD57 confirmed the perineural invasion. Positivity for HMB-45 and MART-1/Melan-A, as well as Fontana-Masson stain (and potassium permanganate bleaching-sensitive), identified the pigment granules as melanin. To the best of our knowledge, this is the first case of intraoral low-grade AdCaNOS with intracytoplasmic melanin granules.

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“…Recently, Ghazali et al (13) reported a patient with HER2-positive metastatic salivary adenocarcinoma who showed complete response to trastuzumab, and summarized 15 published papers, including a prospective study and a case report, presenting details of 56 cases treated with trastuzumab monotherapy or combined chemotherapy. Although the dose and schedule of trastuzumab and combined chemotherapy agents were different between the reports, 22 patients achieved good response.…”

Section: Discussionmentioning

confidence: 99%

Targeted therapy with trastuzumab for epidermal growth factor receptor 2 (HER2)‑positive advanced salivary duct carcinoma: A case report

et al. 2019

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Herein we report two cases of advanced and/or metastatic salivary duct carcinoma that relapsed after standard first-line chemotherapy. As overexpression of human epidermal growth factor receptor 2 (HER2) (3+) was observed by immunohistochemistry, the patients were treated with trastuzumab plus paclitaxel. One patient showed a complete response lasting over 2.5 years after the commencement of therapy; however, the other patient had no response to trastuzumab combined therapy. Dual fluorescence in situ hybridization was performed after the initiation of chemotherapy; the first case was positive for HER2 gene amplification, while the second case was negative. Our experiences suggest that therapy with HER2 blockers should be considered as options for treatment of HER2-positive salivary duct carcinoma. However, HER2 protein overexpression and gene amplification should be investigated further as therapeutic biomarkers.

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Sustained response of HER2-positive metastatic salivary adenocarcinoma, not otherwise specified, treated with trastuzumab

Cited by 7 publications

References 38 publications

Second-Line Treatment of HER2-Positive Salivary Gland Tumor: Ado-Trastuzumab Emtansine (T-DM1) after Progression on Trastuzumab

Second-Line Treatment of HER2-Positive Salivary Gland Tumor: Ado-Trastuzumab Emtansine (T-DM1) after Progression on Trastuzumab

Intraoral Pigmented Low-Grade Adenocarcinoma, Not Otherwise Specified: Case Report and Immunohistochemical Study

Targeted therapy with trastuzumab for epidermal growth factor receptor 2 (HER2)‑positive advanced salivary duct carcinoma: A case report

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