Open AccessTrastuzumab for the Treatment of Salivary Duct Carcinoma
Author(s) -
Limaye Sewanti A.,
Posner Marshall R.,
Krane Jeffrey F.,
Fonfria Maria,
Lorch Jochen H.,
Dillon Deborah A.,
Shreenivas Aditya V.,
Tishler Roy B.,
Haddad Robert I.
Publication year - 2013
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2012-0369
Subject(s) - medicine , trastuzumab , carboplatin , oncology , adjuvant , chemotherapy , malignancy , adjuvant therapy , radiation therapy , surgery , gastroenterology , cancer , breast cancer , cisplatin
Objectives. 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.