Naseem Ghazali1, Lynette Parker2, Kathleen Settle3, Joshua E Lubek4. 1. Division of Oncology & Reconstructive Surgery, Department of Oral & Maxillofacial Surgery, Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA. 2. Department of Pathology, University of Maryland Medical Center, Baltimore, MD, USA. 3. Chesapeake Potomac Regional Cancer Center, Waldorf, MD, USA. 4. Division of Oncology & Reconstructive Surgery, Department of Oral & Maxillofacial Surgery, Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA. Electronic address: jlubek@umaryland.edu.
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.
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.
Authors: Nhu Thuy Can; Mark W Lingen; Heather Mashek; James McElherne; Renee Briese; Carrie Fitzpatrick; Annemieke van Zante; Nicole A Cipriani Journal: Head Neck Pathol Date: 2017-07-05