Case series of docetaxel, trastuzumab, and pertuzumab (DTP) as first line anti-HER2 therapy and ado-trastuzumab emtansine (T-DM1) as second line for recurrent or metastatic HER2-positive salivary duct carcinoma

We report the case of a young, 36-year-old patient diagnosed with multifocal breast carcinoma, undergoing neoadjuvant chemotherapy, surgery and adjuvant treatment. The patient presented an early recovery of liver disease after only 7 months of free interval. Histological reevaluation after liver biopsy revealed a HER2-positive disease, for which it was treated with first line chemotherapy including double anti-HER2 block. After 3 cycles the disease progressed at liver and encephalic level. It was therefore decided to treat brain localizations with whole-brain radiotherapy and to start a second line with capecitabine associated with lapatinib. This chemo-radiotherapy approach allowed to control the disease for 8 months. Following further progression (lymph node and bone), a third line was chosen with trastuzumab emtansine (TDM1). The encephalic disease remained stable for another 8 months, when due to visceral progression and worsening of clinical picture, TDM1 was interrupted and supportive therapies were started (Oncology). .

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Primary and Secondary/ Metastatic Salivary Duct Carcinoma Presenting within the Sinonasal Tract

Head and Neck Pathology ◽

10.1007/s12105-020-01271-8 ◽

2021 ◽

Author(s):

Abbas Agaimy ◽

Sarina K. Mueller ◽

Justin A. Bishop ◽

Simion I. Chiosea

Keyword(s):

Parotid Gland ◽

Pleomorphic Adenoma ◽

Case Series ◽

Sinonasal Tract ◽

Salivary Duct Carcinoma ◽

High Grade ◽

Salivary Duct ◽

Duct Carcinoma ◽

Primary Tumors ◽

Secondary Tumors

AbstractTraditionally, sinonasal adenocarcinomas have been subdivided into intestinal (ITAC) and non-intestinal (non-ITAC) categories. The latter encompasses salivary-type adenocarcinomas originating from the seromucinous glands of the sinonasal mucosa and non-salivary adenocarcinomas. The non-salivary adenocarcinoma category is further subdivided into low-and high-grade variants. Among salivary-type sinonasal adenocarcinomas, tumors recapitulating salivary duct carcinoma (SDC) are exceedingly rare, but some might have been lumped into the high-grade non-ITAC category. To date, only three primary SDCs originating in the sinonasal tract have been reported. We herein describe 7 cases of SDC including one previously reported case (4 primary sinonasal, 3 metastatic/ extension from parotid gland SDC). The primary tumors affected 3 males and one female aged 60 – 75. Different sites were involved by the primary tumors while the secondary tumors affected the sphenoidal (2) and the frontal + maxillary (1) sinuses. Three primary tumors were de novo high-grade SDC and one was confined to contours of a pre-existing pleomorphic adenoma. All 3 secondary tumors were SDC ex pleomorphic adenoma of the parotid with a long history of recurrences, ultimately involving the sinonasal tract. Androgen receptor was positive in 7/7 cases. Four of 6 cases were strongly HER2/neu + (either score 3 + or with verified amplification). This small case series adds to the delineation of primary sinonasal SDC highlighting that almost half of invasive SDC presenting within sinonasal tract indeed represents extension or metastasis from a parotid gland primary. There is a tendency towards overrepresentation of HER2/neu-positive cases in both categories (primary and metastatic), but this needs clarification in larger studies.

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HER2‐positive metastatic, parotid salivary duct carcinoma treated with a trastuzumab/pertuzumab‐based chemotherapy: A case report

Clinical Case Reports ◽

10.1002/ccr3.3209 ◽

2020 ◽

Vol 8 (12) ◽

pp. 2878-2882

Author(s):

Raffaele Longo ◽

Pierre‐Olivier Legros ◽

Marouane Talbi ◽

Marc Wagner ◽

Elena‐Adinisia Paraschiv ◽

...

Keyword(s):

Case Report ◽

Salivary Duct Carcinoma ◽

Salivary Duct ◽

Her2 Positive ◽

Duct Carcinoma

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Combination of docetaxel, trastuzumab and pertuzumab or treatment with trastuzumab-emtansine for metastatic salivary duct carcinoma

Oral Oncology ◽

10.1016/j.oraloncology.2017.06.023 ◽

2017 ◽

Vol 72 ◽

pp. 198-200 ◽

Cited By ~ 16

Author(s):

Wim van Boxtel ◽

Eline Boon ◽

Willem L.J. Weijs ◽

Frank J.A. van den Hoogen ◽

Uta E. Flucke ◽

...

Keyword(s):

Salivary Duct Carcinoma ◽

Trastuzumab Emtansine ◽

Salivary Duct ◽

Duct Carcinoma

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Androgen deprivation therapy for androgen receptor-positive advanced salivary duct carcinoma: A nationwide case series of 35 patients in The Netherlands

Head & Neck ◽

10.1002/hed.25035 ◽

2017 ◽

Vol 40 (3) ◽

pp. 605-613 ◽

Cited By ~ 37

Author(s):

Eline Boon ◽

Wim van Boxtel ◽

Jan Buter ◽

Robert J. Baatenburg de Jong ◽

Robert J. J. van Es ◽

...

Keyword(s):

Androgen Receptor ◽

The Netherlands ◽

Androgen Deprivation Therapy ◽

Case Series ◽

Androgen Deprivation ◽

Salivary Duct Carcinoma ◽

Salivary Duct ◽

Duct Carcinoma

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Ado-trastuzumab emtansine: Avoiding side-effects of traditional HER2 positive breast cancer treatment

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155220985598 ◽

2021 ◽

pp. 107815522098559

Author(s):

Alla Turshudzhyan ◽

James Vredenburgh

Keyword(s):

Breast Cancer ◽

Cancer Treatment ◽

Trastuzumab Emtansine ◽

Second Line ◽

First Line ◽

Her2 Positive ◽

Her2 Positive Breast Cancer ◽

First Line Therapy ◽

Line Therapy ◽

Positive Breast Cancer

Introduction Approach to cancer treatment is dictated by guidelines based on clinical research. New research continuously changes what we consider to be first-line therapy for a given type of cancer. Treatment approach becomes more complex when patient’s cultural beliefs have to be considered and incorporated into the therapy. Case report We are presenting a case of a patient born and raised in the former Soviet Union, whose understanding of how cancer should be treated was considerably different from what we now deem to be first-line therapy. This patient was diagnosed with metastatic HER2 positive breast cancer. Management and outcome: Having reservations about first-line therapy, she wanted to consider surgery as well as other lines of therapy. Her medical team worked on finding an alternative treatment plan that would be in line with her goals of care. Patient’s personal beliefs led her to choose a therapy that is currently a second-line: Ado-trastuzumab emtansine. She was able to achieve full remission. Discussion Some recent studies discussed in this case showed that first-line therapies don’t have significant progression free survival advantage when compared to the second-line therapy that our patient received. Ado-trastuzumab emtansine is a potent cytotoxic drug connected via a stable linker to the anti-HER2 antibody, trastuzumab. More studies need to be done to further investigate positive result presented in this case and whether this could be considered an alternative to current first-line therapy.

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