scholarly journals Complete Response to Trastuzumab-Based Chemotherapy in a Patient with Human Epidermal Growth Factor Receptor-2-Positive Metastatic Salivary Duct Carcinoma ex Pleomorphic Adenoma

2013 ◽  
Vol 6 (3) ◽  
pp. 450-455 ◽  
Author(s):  
Shigenori Kadowaki ◽  
Yasushi Yatabe ◽  
Hitoshi Hirakawa ◽  
Azusa Komori ◽  
Chihiro Kondoh ◽  
...  
2019 ◽  
Vol 37 (2) ◽  
pp. 125-134 ◽  
Author(s):  
Hideaki Takahashi ◽  
Yuichiro Tada ◽  
Takashi Saotome ◽  
Kohei Akazawa ◽  
Hiroya Ojiri ◽  
...  

Purpose Clinical evidence demonstrating the effectiveness of systemic therapy for advanced salivary duct carcinoma (SDC) is lacking because of the disease’s rarity. We assessed the efficacy and toxicity of trastuzumab plus docetaxel in patients with locally advanced and/or recurrent or metastatic human epidermal growth factor receptor 2–positive SDC. Patients and Methods This was a single-center, single-arm, open-label, phase II study in Japan. The patients received trastuzumab at a loading dose of 8 mg/kg, followed by 6 mg/kg every 3 weeks. Docetaxel 70 mg/m2 was administrated every 3 weeks. The primary end point was the overall response rate; the secondary end points included the clinical benefit rate, progression-free survival, overall survival, and toxicity. This study is registered with the University Hospital Medical Information Network Clinical Trials Registry (Identification No. UMIN000009437). Results Fifty-seven eligible patients with SDC were enrolled. The overall response rate was 70.2% (95% CI, 56.6% to 81.6%), and the clinical benefit rate was 84.2% (95% CI, 72.1% to 92.5%). Median progression-free and overall survival times were 8.9 months (95% CI, 7.8 to 9.9 months) and 39.7 months (95% CI, not reached), respectively. The most frequent adverse event was anemia (52 patients [91%]), followed by a decreased WBC count (51 patients [89%]) and neutropenia (50 patients [88%]). The most frequently observed grade 4 adverse event was a decreased neutrophil count (34 patients [60%]). Grade 3 febrile neutropenia was reported in eight patients (14%). No grade 2 or greater adverse events of heart failure or left ventricular ejection fraction decline to less than 50% occurred. Conclusion Our data show encouraging efficacy of trastuzumab plus docetaxel therapy in patients with human epidermal growth factor receptor 2–positive SDC, with a manageable toxicity profile.


2012 ◽  
Vol 126 (S2) ◽  
pp. S2-S7 ◽  
Author(s):  
D T H Wee ◽  
A A Thomas ◽  
P J Bradley

AbstractSalivary duct carcinoma is an aggressive malignancy with a high mortality rate, which phenotypically resembles high-grade breast ductal carcinoma. The parotid gland is the most common location. Standard treatment is surgery to the primary tumour together with post-operative radiotherapy. Despite this, there is a high rate of local recurrence, cervical nodal involvement and distant metastasis. Chemotherapy is currently considered only for end-stage, disseminated disease; however, current evidence indicates that chemotherapy used with radiotherapy may result in improved disease control and survival.Human epidermal growth factor receptor-2 is a proto-oncogene which is over-expressed in both breast ductal carcinoma and salivary duct carcinoma. Clinical studies of patients with metastatic breast cancer, using trastuzumab, a monoclonal antibody directed against human epidermal growth factor receptor-2, have shown significant efficacy in tumour response, resulting in improved survival. Such advances in immunohistochemistry, and in targeted immunotherapy for breast ductal carcinoma, should be applied to the treatment of salivary duct carcinoma.


2008 ◽  
Vol 123 (2) ◽  
pp. 250-252 ◽  
Author(s):  
M Nashed ◽  
R J Casasola

AbstractBackground:The incidence of human epidermal growth factor receptor 2 positivity in salivary duct carcinoma ranges from 25 to 100 per cent and is associated with a poor outcome. Salivary duct carcinoma has significant pathological similarities to ductal carcinoma of the breast.Methods and results:A 49-year-old man developed lung and liver metastasis a few months after surgery and adjuvant radiotherapy for salivary duct carcinoma of the parotid gland. There was no response to palliative chemotherapy with doxorubicin. We followed the biological model of breast cancer, whereby two-thirds of human epidermal growth factor receptor 2 positive patients respond to a combination of docetaxel and human epidermal growth factor receptor 2 blocker (trastuzumab). A durable, complete response was achieved with this combination. A rationalised treatment approach targeting the biological characteristics of salivary duct carcinoma had proven successful.


Author(s):  
Keisuke Arai ◽  
Shingo Kanaji ◽  
Daiki Okamoto ◽  
Ritsuko Maehara ◽  
Masashi Yamamoto ◽  
...  

Abstract ABSTRACT Introduction Perioperative adjuvant treatment for esophagogastric junction adenocarcinoma has been attempted, but efficacy of preoperative therapy is unclear. We report here a case of pathological complete response after preoperative treatment containing trastuzumab in esophagogastric junction adenocarcinoma. Case presentation A 54-year-old man presented at our institute with dysphagia. Esophagogastroduodenoscopy and computed tomography revealed an 8 x 5 cm-sized tumor on the gastric cardia and lower intrathoracic esophagus with invasion to the diaphragm (T4bN0M0, StageIIIB). Biopsy showed a well-differentiated and human epidermal growth factor receptor 2-positive adenocarcinoma. He received 2 cycles of preoperative chemotherapy consisting of trastuzumab, cisplatin, and capecitabine without severe toxicity. Afterwards, he underwent esophagectomy and total gastrectomy with mediastinal and abdominal D2 lymph node dissections. No cancer cells were detected during histopathological examination, indicating pathological complete response. Conclusion Regimens containing trastuzumab are feasible and promising as preoperative chemotherapy for human epidermal growth factor receptor 2-positive esophagogastric junction adenocarcinoma.


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