Dennie Trevor
Multicare Regional Cancer Center, 121 N. Division Street, No. 100, Auburn, WA 98001, USA.
Case Rep Oncol Med. 2015;2015:262357. doi: 10.1155/2015/262357. Epub 2015 Feb 2.
Carcinoma of the lacrimal gland is a rare malignancy, limiting opportunities to develop new therapeutic regimens through clinical trials. There are no standard guidelines on optimal treatment of lacrimal gland carcinoma. In addition, lacrimal gland carcinoma includes several different subtypes with distinct behavior and response to treatment, further complicating treatment. Overexpression of the Her-2/neu protein, a potential target for new therapeutic agents, has previously been described in lacrimal gland carcinoma; however, there are no published reports regarding treatment of lacrimal gland cancer with Her-2 directed medications. This case report describes treatment of a patient with metastatic lacrimal gland carcinoma with lapatinib, an oral agent with activity against Her-2/neu amplified malignancies. In this case, Her-2 overexpression was confirmed by biopsy of a metastatic site. PET imaging obtained 6 months after the initiation of lapatinib showed evidence of a partial response to treatment, although the patient later developed progressive neurologic complications related to her malignancy and ultimately died. Lapatinib and other Her-2 targeted agents may represent an effective therapeutic option for this rare malignancy, in cases of metastatic disease.
泪腺癌是一种罕见的恶性肿瘤，限制了通过临床试验开发新治疗方案的机会。目前尚无关于泪腺癌最佳治疗方法的标准指南。此外，泪腺癌包括几种不同的亚型，其行为和对治疗的反应各不相同，这使得治疗更加复杂。Her-2/neu蛋白的过表达是新型治疗药物的潜在靶点，此前已在泪腺癌中有所描述；然而，尚无关于使用针对Her-2的药物治疗泪腺癌的报道。本病例报告描述了一名转移性泪腺癌患者使用拉帕替尼的治疗情况，拉帕替尼是一种对Her-2/neu扩增的恶性肿瘤有活性的口服药物。在该病例中，通过转移部位活检证实了Her-2过表达。开始使用拉帕替尼6个月后进行的PET成像显示有治疗部分缓解的迹象，尽管患者后来出现了与恶性肿瘤相关的进行性神经并发症并最终死亡。对于转移性疾病的情况，拉帕替尼和其他针对Her-2的药物可能是这种罕见恶性肿瘤的有效治疗选择。
