Department of Investigational Cancer Therapeutics, (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas.
Head Neck. 2014 Mar;36(3):E25-7. doi: 10.1002/hed.23429. Epub 2013 Oct 19.
Salivary ductal carcinoma is a rare cancer with poor prognosis and limited treatment options. Human epidermal receptor 2 (HER2)-directed treatment has been attempted in HER2-amplified or overexpressed salivary gland malignancies with limited success.
We report resolution of measurable disease and minimal residual disease in a patient with salivary duct cancer treated with trastuzumab, lapatinib, and bevacizumab, with treatment ongoing for more than 2 years.
This treatment has been tolerated well except for grade 2 diarrhea and mucositis, which required a dose reduction of lapatinib to 1000 mg daily. The response observed was achieved in spite of receiving extensive prior therapy, including trastuzumab and/or chemotherapy for 20 months on which his tumors progressed.
The combination of trastuzumab, lapatinib, and bevacizumab may warrant investigation as a non-cytotoxic alternative for treatment of HER2-amplified or overexpressed salivary duct carcinoma and other HER2-amplified or overexpressed salivary gland tumors, particularly those not responsive to trastuzumab monotherapy.
唾液腺癌是一种罕见的癌症，预后较差，治疗选择有限。在 HER2 扩增或过表达的唾液腺癌中尝试了针对人表皮受体 2（HER2）的治疗，但效果有限。
我们报告了一名患有唾液腺癌的患者接受曲妥珠单抗、拉帕替尼和贝伐珠单抗治疗后，可测量疾病和微小残留疾病得到缓解，且治疗已持续超过 2 年。
除了 2 级腹泻和黏膜炎外，该治疗方案耐受性良好，需要将拉帕替尼的剂量减少至每天 1000mg。尽管患者接受了广泛的先前治疗，包括曲妥珠单抗和/或化疗 20 个月，肿瘤进展，但观察到的反应仍得以实现。
曲妥珠单抗、拉帕替尼和贝伐珠单抗的联合应用可能值得研究，作为治疗 HER2 扩增或过表达的唾液腺癌和其他 HER2 扩增或过表达的唾液腺肿瘤的非细胞毒性替代方案，特别是那些对曲妥珠单抗单药治疗无反应的肿瘤。
