Details

Autor(en) / Beteiligte

• 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.

Titel

Trastuzumab for the Treatment of Salivary Duct Carcinoma

Ist Teil von

• The oncologist (Dayton, Ohio), 2013-03, Vol.18 (3), p.294-300

Ort / Verlag

Durham, NC, USA: AlphaMed Press

Erscheinungsjahr

2013

Quelle

MEDLINE

Beschreibungen/Notizen

• 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. 摘要 目的. 涎腺导管癌（ SDC）是一种罕见的侵袭性恶性肿瘤，死亡率高，对治疗的应答很差。相当一部分SDC为HER2阳性。本篇回顾性综述探讨了SDC中的HER2检测情况，以及以曲妥珠单抗为基础的方案作为辅助治疗与姑息治疗患者的临床结局。 方法. 总计13例免疫组化检测HER2/neu表达为+ ~ +++的SDC患者接受了曲妥珠单抗辅助治疗（n = 8）或姑息治疗（n =5）。辅助治疗包括同步放疗与每周一次紫杉醇、卡铂和曲妥珠单抗组成的化疗方案（TCH）治疗6周，继以TCH治疗12周，曲妥珠单抗单药治疗1年。对转移性疾病的姑息治疗包括每3周一次TCH，共6个周期，继以曲妥珠单抗（疗程未定）联合或不联合二线化疗（针对疾病进展）。所有患者均通过荧光原位杂交检测HER2/neu基因扩增。 结果. 中位随访时间为27个月（范围：8 ~48个月）。总体上，接受辅助治疗的患者中有62%（5/8）在完成治疗后超过2年的时间内未出现疾病征象。所有转移性疾病患者（5/5）对TCH治疗应答。1例患者获得完全缓解，并在TCH开始治疗52个月后保持无病状态。中位缓解持续时间为18个月（范围：8~ 52个月）。 结论. HER2/neu阳性和应用曲妥珠单抗治疗与患者长期生存和缓解的相关性良好。基于以上数据，本研究建议所有SDC患者应常规检查HER2/neu状态，以便进行更有针对性的治疗。 Salivary duct carcinoma (SDC) is a rare and aggressive malignancy with high mortality and poor response to treatment. This retrospective study found that HER2/neu positivity and treatment with trastuzumab correlated well with long‐term survival and response in adjuvant and palliative settings.