Trastuzumab for the treatment of salivary duct carcinoma. Oncologist 2013;18(3):294-300
Date
02/23/2013Pubmed ID
23429737Pubmed Central ID
PMC3607526DOI
10.1634/theoncologist.2012-0369Scopus ID
2-s2.0-84875469190 (requires institutional sign-in at Scopus site) 153 CitationsAbstract
OBJECTIVE: Salivary duct carcinoma (SDC) is a rare and aggressive malignancy with high mortality and poor response to treatment. A significant fraction of SDCs are HER2 positive. This retrospective review examines HER2 testing in SDC and the outcome of trastuzumab-based therapy in adjuvant and palliative settings.
METHODS: A total of 13 patients with SDC and HER2/neu expression by immunohistochemistry of 1-3+ were treated with trastuzumab in adjuvant (n = 8) or palliative (n = 5) setting. Adjuvant therapy consisted of concurrent radiation and chemotherapy with weekly paclitaxel, carboplatin, and trastuzumab (TCH) for 6 weeks followed by TCH for 12 weeks and trastuzumab alone for 1 year. Palliative treatment for metastatic disease consisted of TCH every 3 weeks for 6 cycles followed by trastuzumab for variable time periods with or without second-line chemotherapy for progression. All patients had fluorescence in situ hybridization testing for HER2/neu gene amplification.
RESULTS: The median duration of follow-up was 27 months (range: 8-48 months). In all, 62% of adjuvant patients (5/8) had no evidence of disease more than 2 years from completion of therapy. All patients with metastatic disease (5/5 patients) responded to treatment with TCH. One patient achieved a complete response and remains with no evidence of disease 52 months after initiation of TCH. The median duration of response was 18 months (range: 8-52 months).
CONCLUSION: HER2/neu positivity and treatment with trastuzumab correlated well with long-term survival and response in our patients. Based on this data, we propose that HER2/neu status be examined routinely in all patients with SDCs and the treatment be directed accordingly.
Author List
Limaye SA, Posner MR, Krane JF, Fonfria M, Lorch JH, Dillon DA, Shreenivas AV, Tishler RB, Haddad RIAuthor
Aditya Shreenivas MD Assistant Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Antibodies, Monoclonal, Humanized
Antineoplastic Combined Chemotherapy Protocols
Carboplatin
Carcinoma, Ductal
Chemoradiotherapy
Chemotherapy, Adjuvant
Female
Humans
Immunohistochemistry
In Situ Hybridization, Fluorescence
Male
Middle Aged
Paclitaxel
Palliative Care
Randomized Controlled Trials as Topic
Receptor, ErbB-2
Retrospective Studies
Salivary Gland Neoplasms
Trastuzumab