Neratinib and the Role of Anti-HER2 Therapy in Salivary Duct Carcinoma

Cancer Rep (Hoboken). 2025 Jan;8(1):e70065. doi: 10.1002/cnr2.70065.

Abstract

Backgroud: Salivary duct carcinoma (SDC) is a rare and aggressive malignancy with a generally dismal prognosis and no standard of care established, despite a known association with epidermal growth factor receptor 2 (HER2) and androgen receptor (AR) over-expression.

Case: We report the case of a 64-year-old female with extra- and intracranial metastases of SDC with evidence of AR and HER2 overexpression. After progression on first line chemotherapy, was administered neratinib, a pan-Erb2 receptor tyrosine kinase inhibitor. Even with central nervous system involvement at diagnosis, a durable clinical response was obtained with a PFS of 11 months and no significant toxicities to manage. Best response observed during tratment was partial response.

Conclusions: This case confirms the potential efficacy of neratinib in HER2-positive SDC and underlines the need to define the best therapeutic sequence and potential biomarkers for these rare patients.

Keywords: HER2 targeted therapy; head and neck; neratinib; precision medicine; salivary duct carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Ductal / drug therapy
  • Carcinoma, Ductal / pathology
  • Female
  • Humans
  • Middle Aged
  • Protein Kinase Inhibitors / therapeutic use
  • Quinolines* / administration & dosage
  • Quinolines* / therapeutic use
  • Receptor, ErbB-2* / antagonists & inhibitors
  • Receptor, ErbB-2* / metabolism
  • Receptors, Androgen / metabolism
  • Salivary Ducts / pathology
  • Salivary Gland Neoplasms* / drug therapy
  • Salivary Gland Neoplasms* / pathology

Substances

  • Receptor, ErbB-2
  • Quinolines
  • ERBB2 protein, human
  • neratinib
  • Protein Kinase Inhibitors
  • Receptors, Androgen