Department of Oncology, Shanghai Fourth People's Hospital, Tongji University School of Medicine, Shanghai 200434, China.
Department of Oncology, Shanghai Fourth People's Hospital, Tongji University School of Medicine, Shanghai 200434, China.
Oral Oncol. 2023 Nov;146:106541. doi: 10.1016/j.oraloncology.2023.106541. Epub 2023 Aug 16.
Carcinoma ex pleomorphic adenoma (CXPA) is a neoplasm of the salivary gland that causes 3.6% of salivary gland tumors and 12% of salivary gland malignancies. Its prognosis is determined by the histological progression beyond the adenoma capsule. CXPA is thought to be a malignant transformation of a primary or recurrent pleomorphic adenoma and is associated with both benign and malignant lesions. Salivary gland cancers represent a rare heterogeneous group of neoplasms with complex clinicopathological characteristics and distinct biological behavior.
This case report summarizes the treatment of a 57-year-old male patient with CXPA of the left parotid gland, harboring HER2 amplification with poor prognosis. The overall survival of the patient has been > 3.5 years. The application and outcome of an immune checkpoint inhibitor and targeted therapy combination regimens in the treatment of CXPA carcinoma are discussed.
Targeted therapy combined with immunotherapy has long-term clinical benefits and targeted therapy which has a high clinical response rate (immunotherapy + dual-targeting three-drug regimens) may present an ideal choice for the treatment of patients with rare and/or refractory tumors without compromising patient safety.
癌肉瘤（Carcinoma ex pleomorphic adenoma，CXPA）是一种发生于唾液腺的肿瘤，占唾液腺肿瘤的 3.6%，占唾液腺恶性肿瘤的 12%。其预后取决于超出腺瘤包膜的组织学进展。CXPA 被认为是原发性或复发性多形性腺瘤的恶性转化，与良性和恶性病变均相关。唾液腺癌是一组罕见的异质性肿瘤，具有复杂的临床病理特征和明显的生物学行为。
本病例报告总结了一位 57 岁男性患者左侧腮腺 CXPA 的治疗情况，该患者存在 HER2 扩增，预后不良。患者的总生存时间>3.5 年。讨论了免疫检查点抑制剂和靶向治疗联合方案在 CXPA 癌治疗中的应用和结果。
靶向治疗联合免疫治疗具有长期的临床获益，且高临床反应率的靶向治疗（免疫治疗+双靶三药方案）可能是治疗罕见和/或难治性肿瘤患者的理想选择，同时不会影响患者的安全性。
