Ghazali Naseem, Parker Lynette, Settle Kathleen, Lubek Joshua E
Division of Oncology & Reconstructive Surgery, Department of Oral & Maxillofacial Surgery, Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA.
Department of Pathology, University of Maryland Medical Center, Baltimore, MD, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Sep;122(3):292-9. doi: 10.1016/j.oooo.2016.03.020. Epub 2016 Apr 20.
Adenocarcinoma-not otherwise specified (AD-NOS) is an aggressive salivary gland carcinoma subtype with poor prognosis. Her2/neu-targeted therapy may be beneficial in cases of overexpression (20% of AD-NOS). Here, a case of metastatic AD-NOS of the submandibular gland showing sustained complete response to trastuzumab is reported, and the existing literature is reviewed.
A 68-year-old male with poorly differentiated AD-NOS of the submandibular gland with multiple metastases (T3 N2 bM1) underwent radical surgery and adjuvant radiation. The primary lesion demonstrated Her2/neu overexpression, and treatment with trastuzumab was initiated. The patient remains alive without evidence of disease at 36-months after treatment (three cycles of trastuzumab). Literature review of all published trastuzumab-based therapy studies (1990-2015) for salivary gland carcinoma is included.
Definitive clinical trials of trastuzumab-based interventions are challenging to undertake in rare tumors. This report adds to increasing evidence for trastuzumab-based therapy in salivary carcinomas, where sustained partial response at 36-months is achievable.
未另行规定的腺癌（AD-NOS）是一种侵袭性唾液腺癌亚型，预后较差。对于过表达的病例（占AD-NOS的20%），针对人表皮生长因子受体2（Her2/neu）的治疗可能有益。本文报告了1例下颌下腺转移性AD-NOS对曲妥珠单抗持续完全缓解的病例，并对现有文献进行了综述。
一名68岁男性，患有低分化下颌下腺AD-NOS并伴有多处转移（T3 N2 bM1），接受了根治性手术和辅助放疗。原发灶显示Her2/neu过表达，遂开始使用曲妥珠单抗治疗。治疗后36个月（三个周期曲妥珠单抗），患者仍存活且无疾病证据。纳入了对所有已发表的基于曲妥珠单抗治疗唾液腺癌的研究（1990 - 2015年）的文献综述。
在罕见肿瘤中开展基于曲妥珠单抗干预的确定性临床试验具有挑战性。本报告进一步增加了基于曲妥珠单抗治疗唾液腺癌的证据，在该治疗中可实现36个月的持续部分缓解。
