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

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Sep;122(3):292-9. doi: 10.1016/j.oooo.2016.03.020. Epub 2016 Apr 20.

Abstract

Objective: Adenocarcinoma-not otherwise specified (AD-NOS) is an aggressive salivary gland carcinoma subtype with poor prognosis. Her2/neu-targeted therapy may be beneficial in cases of overexpression (20% of AD-NOS). Here, a case of metastatic AD-NOS of the submandibular gland showing sustained complete response to trastuzumab is reported, and the existing literature is reviewed.

Study design and results: A 68-year-old male with poorly differentiated AD-NOS of the submandibular gland with multiple metastases (T3 N2 bM1) underwent radical surgery and adjuvant radiation. The primary lesion demonstrated Her2/neu overexpression, and treatment with trastuzumab was initiated. The patient remains alive without evidence of disease at 36-months after treatment (three cycles of trastuzumab). Literature review of all published trastuzumab-based therapy studies (1990-2015) for salivary gland carcinoma is included.

Conclusions: Definitive clinical trials of trastuzumab-based interventions are challenging to undertake in rare tumors. This report adds to increasing evidence for trastuzumab-based therapy in salivary carcinomas, where sustained partial response at 36-months is achievable.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / secondary*
  • Adenocarcinoma / therapy
  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Diagnostic Imaging
  • Humans
  • Liver Neoplasms / pathology
  • Male
  • Neck Dissection
  • Neoplasm Staging
  • Prognosis
  • Receptor, ErbB-2
  • Salivary Gland Neoplasms / drug therapy*
  • Salivary Gland Neoplasms / secondary*
  • Salivary Gland Neoplasms / therapy
  • Sternum / pathology
  • Trastuzumab / therapeutic use*

Substances

  • Antineoplastic Agents
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Trastuzumab