1
|
Brennan C, Al Bakry M, Fort-Schaale A, Jose J, Mizen K, Matteucci P, Kelemen N. Immediate lengthening temporalis myoplasty for facial palsy reconstruction following facial nerve inclusive total parotidectomy. Int J Oral Maxillofac Surg 2024; 53:724-730. [PMID: 38395687 DOI: 10.1016/j.ijom.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 02/25/2024]
Abstract
Immediate lengthening temporalis myoplasty (Labbé procedure) for immediate dynamic facial reanimation after nerve-inclusive parotidectomy in the elderly population is undocumented in the literature. The aim of this work was to determine whether the Labbé approach could achieve immediate, good functional and static results in elderly patients with acquired facial palsy. A retrospective analysis of five patients with parotid malignancies involving the facial nerve who underwent parotidectomy and an immediate Labbé procedure was performed. The House-Brackmann and Sunnybrook scores for facial palsy were used as objective measurements of the functional outcome. All patients underwent total parotidectomy, neck dissection, Labbé procedure, immediate temporary tarsorrhaphy, brow lift, and postoperative radiotherapy. Mean patient age was 83 (range 73-87) years. The average resected tumour size was 3.54 cm. The mean duration of surgery was 324 min and length of hospital stay 4 days. All patients experienced an improvement in House-Brackmann of one grade postoperative (grade V to IV in four, grade VI to V in one); the Sunnybrook score improved by 31 points on average (mean preoperative 3.8 vs postoperative 34.8). An immediate Labbé procedure following ablative parotid malignancy resection is a reliable and safe reconstructive procedure in a carefully selected elderly population, providing acceptable immediate static and dynamic hemifacial mimetic function and eliminating an additional facial palsy correction procedure.
Collapse
Affiliation(s)
- C Brennan
- Plastic and Reconstructive Surgery Department, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol, UK.
| | - M Al Bakry
- Hull York Medical School, Heslington, York, UK
| | - A Fort-Schaale
- Plastic and Reconstructive Surgery Department, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol, UK
| | - J Jose
- Plastic and Reconstructive Surgery Department, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Cottingham, Hull, UK
| | - K Mizen
- Plastic and Reconstructive Surgery Department, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Cottingham, Hull, UK
| | - P Matteucci
- Plastic and Reconstructive Surgery Department, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Cottingham, Hull, UK
| | - N Kelemen
- Plastic and Reconstructive Surgery Department, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Cottingham, Hull, UK
| |
Collapse
|
2
|
Honma Y, Monden N, Yamazaki K, Kano S, Satake H, Kadowaki S, Utsumi Y, Nakatogawa T, Takano R, Fujii K, Koroki Y, Aoyama J, Ouchi S, Ogawa T, McCarthy S, Brookman-May SD, Mundle S, Li J, Thaper D, Nagao T, Tada Y. Apalutamide and Goserelin for Androgen Receptor-Positive Salivary Gland Carcinoma: A Phase II Nonrandomized Clinical Trial, YATAGARASU. Clin Cancer Res 2024; 30:3416-3427. [PMID: 38940667 DOI: 10.1158/1078-0432.ccr-24-0455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 04/09/2024] [Accepted: 06/26/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE To assess the efficacy and safety of apalutamide plus goserelin for androgen receptor (AR)-positive unresectable or recurrent/metastatic salivary gland carcinoma. PATIENTS AND METHODS This trial was an open-label, single-arm, multicenter phase II study. Patients with histologically confirmed unresectable or recurrent/metastatic salivary gland carcinoma with AR expression were included. The primary endpoint was the overall response rate (ORR) according to RECIST v1.1 by an independent central radiology review in the first 24 response-evaluable (RE) patients who had been observed at least 24 weeks from study initiation (primary RE patients). The efficacy was to be declared when at least 8 of the 24 primary RE patients responded. RESULTS A total of 31 patients were enrolled. In the first 24 primary RE patients with a median follow-up of 7.4 months, confirmed ORR by independent central radiology review was 25.0% [6/24 patients; 95% confidence interval, 9.8%-46.7%; P = 0.11 (one-sided)], which did not meet the predefined criteria of efficacy. Clinical benefit rate (ORR + rate of stable disease for at least 24 weeks) and median progression-free survival were 50.0% and 7.4 months, respectively. Both median duration of response and overall survival were not reached. Exploratory analyses showed a better ORR of 54.5% (6/11) in patients with AR positivity ≥70% and no history of prior systemic therapy. Grade 3 or higher treatment-emergent adverse events were reported in 35.5% (11/31), which included skin rash, anemia, leukopenia, and cancer pain. CONCLUSIONS Although this study did not meet the predefined efficacy criteria, apalutamide plus goserelin showed clinically meaningful efficacy in a subset of patients with AR-positive salivary gland carcinoma and safety consistent with prior experience in prostate cancer.
Collapse
Affiliation(s)
- Yoshitaka Honma
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Nobuya Monden
- Department of Head and Neck, Surgery, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Keisuke Yamazaki
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medical, and Dental Sciences, Niigata University, Niigata, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Hironaga Satake
- Cancer Treatment Center, Kansai Medical University Hospital, Osaka & Department of Medical Oncology, Kochi Medical School, Kochi, Japan
| | - Shigenori Kadowaki
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Yoshitaka Utsumi
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | | | - Ryo Takano
- Janssen Pharmaceutical K.K., Tokyo, Japan
| | - Koji Fujii
- Janssen Pharmaceutical K.K., Tokyo, Japan
| | | | | | | | | | - Sharon McCarthy
- Janssen Research & Development, Spring House, Pennsylvania, USA
| | - Sabine D Brookman-May
- Janssen Research & Development, Spring House, Pennsylvania, USA
- Ludwig-Maximilians University (LMU), Munich, Germany
| | - Suneel Mundle
- Janssen Research & Development, Spring House, Pennsylvania, USA
| | - Jinhui Li
- Janssen Research & Development, Spring House, Pennsylvania, USA
| | - Daksh Thaper
- Janssen Research & Development, Spring House, Pennsylvania, USA
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| |
Collapse
|
3
|
Mayer M, Wolber P, Prinz J, Jansen L, Esser J, Shabli S, Quaas A, Klußmann JP, Sharma SJ, Nachtsheim L, Arolt C. The extent of androgen receptor and HER2 expression allows for targeted therapy in most cases of salivary duct carcinoma: analysis of clinical and histopathological data in a tertiary care center. Eur Arch Otorhinolaryngol 2024; 281:3779-3789. [PMID: 38587651 PMCID: PMC11211117 DOI: 10.1007/s00405-024-08627-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
PURPOSE The incidence of salivary duct carcinoma (SDC) seems to be underestimated due to inaccurate classification. Further, the frequency of SDC patients with targeted therapy options according to current guidelines is unclear. Therefore, this study aimed at (a) describing the proportion of SDC among salivary gland carcinoma (SGC) before and after reclassification of cases initially classified as adenocarcinoma, not otherwise specified (ANOS); and (b) quantifying the frequency of SDC patients with targeted therapy options. METHODS All patients with SDC or ANOS treated in a tertiary care center between 1996 and 2023 were identified. Histopathological diagnosis was verified for patients primarily diagnosed with SDC and reviewed for patients initially diagnosed with ANOS. Clinical data for SDC patients were retrieved from clinical charts. Immunohistochemical (IHC) androgen receptor (AR) and HER2 staining was performed. RESULTS Among 46 SDC, 34 were primarily diagnosed as SDC and 12 had initially been classified as ANOS. The proportion of SDC among SGC was 12.1% and was rising when comparing the time periods 2000-2015 (7.1-11.5%) versus 2016-2023 (15.4-18.1%). Nuclear AR staining in > 70% of tumor cells was found in 56.8% and HER2 positivity (IHC 3 +) in 36.4% of cases. 70.5% of patients showed AR staining in > 70% of tumor cells and/or HER2 positivity and therefore at least one molecular target. 5-year overall and disease-free survival (DFS) were 62.8% and 41.0%. Multivariate Cox regression revealed positive resection margins (HR = 4.0, p = 0.03) as independent negative predictor for DFS. CONCLUSIONS The results suggest a rising SDC incidence and show that the extent of the AR and HER2 expression allows for targeted therapy in most SDC cases.
Collapse
Affiliation(s)
- Marcel Mayer
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany.
- Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne, Cologne, Germany.
| | - Philipp Wolber
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne, Cologne, Germany
| | - Johanna Prinz
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
| | - Louis Jansen
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne, Cologne, Germany
| | - Julia Esser
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne, Cologne, Germany
| | - Sami Shabli
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne, Cologne, Germany
| | - Alexander Quaas
- Institute of Pathology, Medical Faculty, University of Cologne, Cologne, Germany
| | - Jens Peter Klußmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne, Cologne, Germany
| | - Shachi Jenny Sharma
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne, Cologne, Germany
| | - Lisa Nachtsheim
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne, Cologne, Germany
| | - Christoph Arolt
- Institute of Pathology, Medical Faculty, University of Cologne, Cologne, Germany
| |
Collapse
|
4
|
Utsumi Y, Nakaguro M, Tada Y, Nagao T. High-grade salivary carcinomas: A current insight on diagnostic pathology and the key to clinical decision making. Semin Diagn Pathol 2024; 41:197-206. [PMID: 38658249 DOI: 10.1053/j.semdp.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
High-grade carcinomas of the salivary glands are a group of several tumor entities with highly malignant histologic appearances, and have an aggressive biological behavior accompanied by poor a prognosis. In general, they require more intensive treatment than low- or intermediate-grade carcinomas. High-grade salivary carcinomas are rare and the microscopic features often overlap between different tumor types, making an appropriate diagnosis challenging in daily practice settings. However, with recent rapid advances in molecular pathology and molecular-targeted therapy in this field, there is a growing need to properly classify tumors, rather than just diagnosing the cases as "high-grade carcinomas". This leads to specific treatment strategies. In this article, we review representative high-grade salivary gland carcinomas, including salivary duct carcinoma and its histologic subtypes, high-grade mucoepidermoid carcinoma, solid-type adenoid cystic carcinoma, and high-grade transformation of low- or intermediate-grade carcinomas, and discuss their differential diagnoses and clinical implications. Other rare entities, such as neuroendocrine carcinoma, NUT carcinoma, and metastatic carcinoma, should also be considered before diagnosing high-grade carcinoma, NOS. Of these tumors, salivary duct carcinoma has received the most attention because of its strong association with androgen deprivation and anti-HER2 therapies. Other tumor-type-specific treatments include anti-TRK therapy for high-grade transformation of secretory carcinoma, but further therapeutic options are expected to be developed in the future. It should be emphasized that detailed histological evaluation with adequate sampling, in addition to the effective use of molecular ancillary tests, is of the utmost importance for a suitable diagnosis.
Collapse
Affiliation(s)
- Yoshitaka Utsumi
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Masato Nakaguro
- Departments of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Yuichiro Tada
- Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan.
| |
Collapse
|
5
|
An M, Zuo J, Yuan F, Xiong P. The prognostic value of selective neck dissection in early-stage major salivary gland carcinoma: a population-based analysis. Front Oncol 2024; 14:1347339. [PMID: 38841169 PMCID: PMC11150835 DOI: 10.3389/fonc.2024.1347339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/29/2024] [Indexed: 06/07/2024] Open
Abstract
Objective This population-based study aims to assess the survival benefits of selective neck dissection (SND) compared to neck observation in patients with T1/T2N0M0 major salivary gland malignancy (MSGC). Methods We conducted a retrospective review of T1/T2N0M0 MSGC patients who underwent primary tumor surgical extirpation with or without elective neck dissection in the Surveillance, Epidemiology, and End Results database (SEER) from 2004-2015. The impact of SND and clinical variables on overall survival (OS) and disease-specific survival (DSS) was evaluated using Univariate and Multivariate Cox proportional hazards regression models. Kaplan-Meier survival curves were generated, and survival rates were assessed via the log-rank test. Results Of 3778 post-operative T1-T2N0M0 MSGC patients, 2305 underwent elective neck dissection, while 1473 did not. Median follow-up was 106 months. Univariate and Multivariate analysis identified SND as a prognostic factor for OS in all the study population. After stratified analysis, we found that in the poorly high-grade (differentiated and undifferentiated) patients, the survival showed a significant OS and DSS benefit after receiving SND compared with the neck observations [HR for OS (95%CI): 0.571(0.446-0.731), P<0.001] and [HR for DSS (95%CI): 0.564(0.385-0.826), P=0.003], other than in the well differentiated or moderately differentiated subgroup. Especially, when the pathological is squamous cell carcinoma, the results show that the people underwent SND had better prognosis, not only in OS [HR (95%CI): 0.532(0.322-0.876), P=0.013], but also in DSS [HR (95%CI): 0.330(0.136-0.797), P=0.014]. The multivariate analysis also yielded encouraging results, compared with neck observation, receiving SND bought about a significant independent OS (adjusted HR, 0.555; 95% CI, 0.328-0.941; P=0.029) and DSS (adjusted HR, 0.349; 95% CI, 0.142-0.858; P=0.022) advantage in high grade squamous cell carcinoma MSGC patients. The Kaplan-Meier survival curves also demonstrated that adjusted SND still had significantly better OS(P=0.029) and DSS(P=0.022) than the observation group in patients with high-grade squamous cell carcinoma of MSGC. Conclusion Poorly differentiated and undifferentiated T1/T2N0M0 major salivary gland malignancy treated with selective neck dissection demonstrated superior survival compared to neck observation, especially in the pathological subtype of squamous cell carcinoma. These findings suggest the potential benefits of multimodal therapy for appropriately selected patients, emphasizing significant clinical implications.
Collapse
Affiliation(s)
| | | | - Fang Yuan
- Department of Ultrasound, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ping Xiong
- Department of Ultrasound, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
6
|
Han EJ, Mukdad LA, Alhiyari Y, Nakhla MN, Sajed DP, St. John MA. A 22-year single institution review of 119 cases of salivary duct carcinoma. Laryngoscope Investig Otolaryngol 2024; 9:e1234. [PMID: 38525121 PMCID: PMC10960238 DOI: 10.1002/lio2.1234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/29/2023] [Accepted: 02/25/2024] [Indexed: 03/26/2024] Open
Abstract
Objective Salivary duct carcinoma (SDC) is a rare and aggressive salivary gland malignancy. Herein, we present the largest single-institution review of SDC to date. Methods This is a retrospective cohort study of all histologically confirmed cases of SDC seen at our institution from January 1, 2002, to August 1, 2022. Patient demographics, treatment, histological characteristics, tumor staging, and outcomes were extracted from the electronic medical record. Kaplan-Meier and Cox regression survival analyses were performed. Results This study included 119 patients with a mean age of 66.2 years. Most primary tumors arose from the parotid gland (72.3%), and 23.5% were noted to be carcinoma ex-pleomorphic adenoma. 57.1% of patients presented with regional lymph node metastasis, whereas 23.5% presented with distant disease. Kaplan-Meier analysis demonstrated a 62.4% 5-year overall survival (OS) and a 69.0% 5-year disease-specific survival (DSS). Univariate analyses indicated that presence of regional lymph node disease (p<.001), distant metastasis (p<.001), perineural invasion (p = .027), and lymphovascular invasion (p = .018) were predictive of decreased OS and DSS. Trastuzumab administration was not associated with survival in HER-2-positive patients receiving chemotherapy. Multivariate analyses demonstrated that presence of nodal disease (HR 30.337, 95% CI 2.782-330.851, p = .005) and carcinoma ex pleomorphic adenoma (HR 5.54, 95% CI 1.024-29.933, p = .047) were associated with decreased OS. Conclusion Our patients had more favorable survival rates compared to prior studies, which may be due to lower incidence of nodal disease. Factors associated with worse survival included nodal and distant metastases, perineural invasion, lymphovascular invasion, and tumor size. Level of Evidence Level 3.
Collapse
Affiliation(s)
- Ethan J. Han
- Department of Head & Neck SurgeryUCLALos AngelesCaliforniaUSA
| | - Laith A. Mukdad
- Department of Head & Neck SurgeryUCLALos AngelesCaliforniaUSA
| | - Yazeed Alhiyari
- Department of Head & Neck SurgeryUCLALos AngelesCaliforniaUSA
| | | | - Dipti P. Sajed
- Department of Pathology and Laboratory Medicine, David Geffen School of MedicineUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Maie A. St. John
- Department of Head & Neck SurgeryUCLALos AngelesCaliforniaUSA
- UCLA Head and Neck Cancer ProgramUCLA Medical CenterLos AngelesCaliforniaUSA
- Jonsson Comprehensive Cancer CenterUCLA Medical CenterLos AngelesCaliforniaUSA
| |
Collapse
|
7
|
Kishimoto K, Shibagaki K, Araki A, Murakami K, Takahashi Y, Kotani S, Oka A, Yazaki T, Fukuba N, Mishima Y, Oshima N, Kawashima K, Ishimura N, Kadota K, Ishihara S. Gastric Metastasis from Salivary Duct Carcinoma Mimicking Scirrhous Gastric Cancer. Intern Med 2024; 63:373-378. [PMID: 37344429 PMCID: PMC10901704 DOI: 10.2169/internalmedicine.1965-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
A 59-year-old man underwent submandibular gland excision for salivary duct carcinoma (SDC). One year later, esophagogastroduodenoscopy indicated gastric diffuse mucosal thickening with luminal contraction, mimicking scirrhous gastric carcinoma. Biopsy specimens showed dense proliferation of neoplastic cells expressing androgen receptor and human epidermal growth factor 2, indicating SDC. Gastric diffuse infiltrative metastasis is generally characteristic of gastric metastasis from invasive ductal carcinoma, which shows histologic features similar to SDC. This is the first known report of gastric diffusely infiltrating metastasis in an SDC patient. Rapidly progressing, diffuse gastric wall thickening should also be considered indicative of salivary tumor-associated gastric metastasis.
Collapse
Affiliation(s)
- Kenichi Kishimoto
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | | | - Asuka Araki
- Department of Pathology, Faculty of Medicine, Shimane University, Japan
| | - Kotaro Murakami
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Yusuke Takahashi
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Satoshi Kotani
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Akihiko Oka
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Tomotaka Yazaki
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Nobuhiko Fukuba
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Yoshiyuki Mishima
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Naoki Oshima
- Department of Endoscopy, Shimane University Hospital, Japan
| | - Kousaku Kawashima
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Norihisa Ishimura
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Kyuichi Kadota
- Department of Pathology, Faculty of Medicine, Shimane University, Japan
| | - Shunji Ishihara
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| |
Collapse
|
8
|
Filippini DM, Pagani R, Tober N, Lorini L, Riefolo M, Molinari G, Burato A, Alfieri S, Bossi P, Presutti L. HER2-targeted therapies for salivary gland cancers. Oral Oncol 2024; 148:106612. [PMID: 38016228 DOI: 10.1016/j.oraloncology.2023.106612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/20/2023] [Accepted: 10/29/2023] [Indexed: 11/30/2023]
Abstract
Salivary gland cancers (SGCs) are a heterogeneous group of rare tumors including various histological subtypes with different molecular profiling. Human epidermal growth factor receptor 2 (HER2) is one of the most intriguing and studied molecular alterations with prognostic and predictive roles. Indeed, HER2 overexpression is commonly correlated with aggressive histological subtypes and poorer prognosis. However, HER2 may represent the target of personalized treatment. We performed a literature review of use of anti-HER2 targeted agents for treatment of recurrent or metastatic SGCs. The efficacy and safety of anti-HER2 were firstly evaluated in patients affected with other solid tumors, mostly breast and gastric cancers. For SGCs the literature is mainly comprised of case reports or case series and small clinical trials. The most common used drug is trastuzumab in combination with chemotherapy (i.e. taxanes, capecitabine, carboplatin, eribulin) or with another anti-HER2 targeted agent (i.e. pertuzumab). The use of anti-HER2 therapies induces improvement in clinical responses, which are mostly durable. Besides, new anti-HER2 drugs such as antibody-drug conjugates (ADC) (i.e. trastuzumab emtansine, trastuzumab deruxtecan) have been introduced in this setting inducing further therapeutic advances. Anti-HER2 treatment strategy is emerging as potentially effective in selected HER2 overexpressing SGCs. However, prospective and multicentric clinical trials are needed to evaluate the efficacy of these therapeutic regimens within larger cohorts and to assess the most appropriate treatment sequence strategy.
Collapse
Affiliation(s)
- Daria Maria Filippini
- Division of Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, Università di Bologna, 40138 Bologna, Italy.
| | - Rachele Pagani
- Division of Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
| | - Nastassja Tober
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Azienda Ospedaliera Maggiore Della Caritá, Novara, Italy
| | - Luigi Lorini
- IRCCS Humanitas Research Hospital, Medical Oncology and Hematology Unit, 20089 Rozzano (Milan), Italy
| | - Mattia Riefolo
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Giulia Molinari
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, Università di Bologna, 40138 Bologna, Italy; Department of Otolaryngology - Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Arianna Burato
- Department of Otolaryngology - Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Salvatore Alfieri
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Paolo Bossi
- IRCCS Humanitas Research Hospital, Medical Oncology and Hematology Unit, 20089 Rozzano (Milan), Italy; Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
| | - Livio Presutti
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, Università di Bologna, 40138 Bologna, Italy; Department of Otolaryngology - Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| |
Collapse
|
9
|
Boey JJH, Ng KYY, Krisnadi C, Lim DWT, Ang MK. Response to fam-Trastuzumab-Deruxtecan in patients with metastatic HER2-positive salivary duct carcinoma: A case series. Oral Oncol 2023; 146:106566. [PMID: 37741018 DOI: 10.1016/j.oraloncology.2023.106566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 09/04/2023] [Indexed: 09/25/2023]
Affiliation(s)
- Jaryl Jia Hao Boey
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Kennedy Yao Yi Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Cindy Krisnadi
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | | | - Mei-Kim Ang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore; Oncology Academic Programme, Duke-NUS Medical School, Singapore.
| |
Collapse
|
10
|
Lee J, Park S, Jung HA, Lee SH, Seo S, Kim SB, Kim JW, Lee KW, Kang EJ, Kim JW, Choi YJ, Shim BY, An HJ, Park LC, Shin SH, Kim JJ, Oh SY, Kim MK, Ahn MJ. A phase 2 multicenter study of docetaxel-PM and trastuzumab-pkrb combination therapy in recurrent or metastatic salivary gland carcinomas. Cancer 2023; 129:2966-2974. [PMID: 37246414 DOI: 10.1002/cncr.34892] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/24/2023] [Accepted: 04/18/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Salivary duct carcinoma (SDC) is uncommon but is the most aggressive subtype of salivary gland carcinomas. The high positivity rate for human epidermal growth factor receptor 2 (HER2) led to an investigation of the efficacy of HER2-targeted agents. Docetaxel-PM (polymeric micelle) is a low-molecular-weight, nontoxic, biodegradable, and docetaxel-loaded micellar formulation. Trastuzumab-pkrb is a biosimilar to trastuzumab. METHODS This was a multicenter, single-arm, open-label phase 2 study. Patients with HER2-positive (immunohistochemistry [IHC] score of ≥2+ and/or HER2/chromosome enumeration probe 17 [CEP17] ratio of ≥2.0) advanced SDCs were enrolled. Patients received docetaxel-PM (75 mg/m2 ) and trastuzumab-pkrb (8 mg/kg in the first cycle and 6 mg/kg in subsequent cycles) every 3 weeks. Primary end point was objective response rate (ORR). RESULTS A total of 43 patients were enrolled. The best objective responses were partial response in 30 (69.8%) patients and stable disease in 10 (23.3%) patients, leading to an ORR of 69.8% (95% confidence interval [CI], 53.9-82.8) and a disease control rate of 93.0% (80.9-98.5). Median progression-free survival, duration of response, and overall survival were 7.9 (6.3-9.5), 6.7 (5.1-8.4), and 23.3 (19.9-26.7) months, respectively. Patients with HER2 IHC score of 3+ or HER2/CEP17 ratio ≥2.0 demonstrated better efficacies compared to those with HER2 IHC score of 2+. Thirty-eight (88.4%) patients experienced treatment-related adverse events (TRAE). Because of TRAE, nine (20.9%), 14 (32.6%), and 19 (44.2%) patients required temporary discontinuation, permanent discontinuation, or dose reduction, respectively. CONCLUSIONS The combination of docetaxel-PM and trastuzumab-pkrb demonstrated promising antitumor activity with a manageable toxicity profile in HER2-positive advanced SDC. PLAIN LANGUAGE SUMMARY Salivary duct carcinoma (SDC) is uncommon but is the most aggressive subtype of salivary gland carcinomas. SDC shares morphological and histological similarities with invasive ductal carcinoma of breast, which led to an investigation of hormonal receptor and human epidermal growth factor receptor 2 (HER2)/neu expression status in SDC. In this study, patients with HER2-positive SDC were enrolled and treated with combination of docetaxel-polymeric micelle and trastuzumab-pkrb. Promising antitumor activities were shown with objective response rate of 69.8%, disease control rate of 93.0%, median progression-free survival of 7.9 months, median duration of response of 6.7 months, and median overall survival of 23.3 months.
Collapse
Affiliation(s)
- Jiyun Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sehhoon Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Ae Jung
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se-Hoon Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seyoung Seo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Bae Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji-Won Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Keun-Wook Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Eun Joo Kang
- Division of Medical Oncology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Ju Won Kim
- Division of Oncology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yoon Ji Choi
- Division of Oncology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Byoung-Yong Shim
- Department of Medical Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Ho-Jung An
- Department of Medical Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Lee Chun Park
- Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Seong Hoon Shin
- Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Jae-Joon Kim
- Medical Oncology and Hematology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
| | - So Yeon Oh
- Medical Oncology and Hematology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
| | - Min Kyoung Kim
- Department of Oncology/Hematology, Yeungnam University Hospital, Daegu, Korea
| | - Myung-Ju Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
11
|
McAfee JL, Hoda RS, Hoyle C, McCoy L, Sprague C, Reddy CA, Koyfman SA, Geiger JL, Komforti MK, Griffith CC. ERBB2 Amplification and HER2 Expression in Salivary Duct Carcinoma: Evaluation of Scoring Guidelines and Potential for Expanded Anti-HER2 Therapy. Mod Pathol 2023; 36:100273. [PMID: 37423585 DOI: 10.1016/j.modpat.2023.100273] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/09/2023] [Accepted: 06/30/2023] [Indexed: 07/11/2023]
Abstract
Salivary duct carcinoma (SDC) is aggressive with limited therapeutic options. A subset of SDC display human epidermal growth factor receptor 2 (HER2) protein overexpression by immunohistochemistry, and some show ERBB2 gene amplification. Guidelines for HER2 scoring are not firmly established. Recent advances in breast carcinoma have established a role for anti-HER2 therapies in lesions with low HER2 expression lacking ERBB2 amplification. Delineating HER2 staining patterns in SDC is critical for evaluating anti-HER2 treatments. In total, 53 cases of SDC resected at our institution between 2004 and 2020 were identified. Androgen receptor (AR) and HER2 immunohistochemistry and ERBB2 fluorescence in situ hybridization were performed in all cases. AR expression was scored for percentage positive cells and categorized as positive (>10% of cells), low positive (1%-10%), or negative (<1%). HER2 staining levels and patterns were recorded, scored using 2018 ASCO/CAP guidelines, and categorized into HER2-positive (3+ or 2+ with ERBB2 amplification), HER2-low (1+ or 2+ without ERBB2 amplification), HER2-very low (faint staining in <10% of cells), or HER2-absent types. Clinical parameters and vital status were recorded. Median age was 70 years, with a male predominance. ERBB2-amplified tumors (11/53; 20.8%) presented at lower pT stages (pTis/pT1/pT2; P = .005, Fisher exact test) and more frequently had perineural invasion (P = .007, Fisher exact test) compared with ERBB2 nonamplified tumors; no other pathologic features differed significantly by gene amplification status. In addition, 2+ HER2 staining by 2018 ASCO/CAP criteria was most common (26/53; 49%); only 4 cases (8%) were HER2-absent status; 3+ HER2 staining was found in 9 tumors, and all were ERBB2 amplified. Six patients with HER2-expressing tumors received trastuzumab therapy, including 2 with ERBB2-amplified tumors. Overall survival and recurrence-free survival did not differ significantly based on ERBB2 status. This work suggests that 2018 ASCO/CAP guidelines for HER2 evaluation in breast carcinoma could be applied to SDC. Our findings also show broad overexpression of HER2 in SDC raising the possibility that more patients may benefit from anti-HER2-directed therapies.
Collapse
Affiliation(s)
- John L McAfee
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Raza S Hoda
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Carrie Hoyle
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Lauren McCoy
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Cathy Sprague
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | | | | | | | - Miglena K Komforti
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida
| | | |
Collapse
|
12
|
Wotman M, El-Naggar A, Ferrarotto R. Targeting human EGFR 2 (HER2) in salivary gland carcinoma. Expert Rev Anticancer Ther 2023; 23:573-582. [PMID: 37114470 DOI: 10.1080/14737140.2023.2208350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
INTRODUCTION Human epidermal growth factor receptor 2 (HER2) protein overexpression, gene amplification, and activating mutations have been identified in a subset of salivary gland carcinoma (SGC) histologies (HER2-positive), especially in salivary duct carcinoma, and represent an important therapeutic target. AREAS COVERED The evidence for targeting HER2 in the adjuvant setting is limited to small retrospective series. Conversely, there are prospective trials supporting the use of anti-HER2 therapy in patients with unresectable, recurrent, or metastatic HER2-positive SGC, including trastuzumab plus docetaxel, trastuzumab plus pertuzumab, trastuzumab-pkrb plus nanoxel, trastuzumab emtansine (T-DM1), and trastuzumab deruxtecan (T-Dxd). EXPERT OPINION HER2-targeting should be considered for patients with advanced HER2-positive SGC. There are no data to guide the selection of one anti-HER2 agent over another in the palliative setting. Trastuzumab plus docetaxel can be considered for patients with a high disease burden, while trastuzumab plus pertuzumab is a good option for patients with low disease burden or borderline performance status. T-DM1 or T-Dxd can be considered upon disease progression on trastuzumab-combination therapies, although these antibody-drug conjugates can also be used upfront. Future research should investigate predictive biomarkers, the combination of HER2 and androgen blockade, and the application of novel therapies from breast cancer.
Collapse
Affiliation(s)
- Michael Wotman
- Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Adel El-Naggar
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Renata Ferrarotto
- Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
13
|
Zhang D, Li L. Prognostic models for estimating survival of salivary duct carcinoma: a population-based study. Eur Arch Otorhinolaryngol 2023; 280:1939-1954. [PMID: 36422671 DOI: 10.1007/s00405-022-07755-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE In a large salivary duct carcinoma (SDC) cohort, we aimed to investigate the clinical factors influencing their survival outcomes and to further establish prognostic models. METHODS Data of patients with SDC were extracted from the Surveillance, Epidemiology, and End Results database (1975-2019). A retrospective analysis was conducted to explore the prognostic factors on overall survival (OS) and disease-specific survival (DSS), and corresponding nomograms were established. RESULTS A steady upward trend in the incidence of SDC was observed over the past four decades. Totally, 399 patients (280 in the training set and 199 in the testing set) were enrolled. Advanced T stage, lymph node metastasis, distant metastasis, and surgery were associated with favorable OS and DSS. Besides, age > 80 years exhibited worse OS. The selected variables above were used to construct nomograms and online web calculators that could accurately predict patient survival. In addition, risk stratification systems were generated to identify low- and high-risk patients. As the risk level increased, the risk of both patient mortality and disease-specific mortality increased. CONCLUSIONS The SDC incidence was low, but steadily increasing. The proposed prognostic models provided a robust and efficient approach to predict survival and risk stratification in SDC patients.
Collapse
Affiliation(s)
- Di Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Panjiayuan nanli No.17, Beijing, 100021, China
| | - Lixi Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Panjiayuan nanli No.17, Beijing, 100021, China.
| |
Collapse
|
14
|
Weaver AN, Lakritz S, Mandair D, Ulanja MB, Bowles DW. A molecular guide to systemic therapy in salivary gland carcinoma. Head Neck 2023; 45:1315-1326. [PMID: 36859797 DOI: 10.1002/hed.27307] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/09/2022] [Accepted: 01/16/2023] [Indexed: 03/03/2023] Open
Abstract
Salivary gland carcinomas (SGC) are a rare and variable group of head and neck cancers with historically poor response to cytotoxic chemotherapy and immunotherapy in the recurrent, advanced, and metastatic settings. In the last decade, a number of targetable molecular alterations have been identified in SGCs including HER2 upregulation, androgen receptor overexpression, Notch receptor activation, NTRK gene fusions, and RET alterations which have dramatically improved treatment outcomes in this disease. Here, we review the landscape of precision therapy in SGC including current options for systemic management, ongoing clinical trials, and promising future directions.
Collapse
Affiliation(s)
- Alice N Weaver
- Division of Medical Oncology, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Stephanie Lakritz
- Division of Medical Oncology, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Divneet Mandair
- Division of Hematology/Oncology, University of San Francisco California, San Francisco, California, USA
| | - Mark B Ulanja
- Christus Ochsner St. Patrick Hospital, Lake Charles, Louisiana, USA
| | - Daniel W Bowles
- Division of Medical Oncology, University of Colorado School of Medicine, Denver, Colorado, USA.,Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| |
Collapse
|
15
|
Williams CYK, Townson AT, Terry N, Schmitt NC, Sharma A. Role of HER2 in Prognosis of Salivary Duct Carcinoma: A Systematic Review and Meta-Analysis. Laryngoscope 2023; 133:476-484. [PMID: 35567387 DOI: 10.1002/lary.30214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Salivary duct carcinoma (SDC) is a rare, aggressive malignancy with a poor prognosis. These tumors frequently stain positive for HER2/ErbB2, but data on the prognostic significance of HER2 status in SDC are mixed. We sought to determine whether HER2 status affects survival outcomes in SDC. METHODS PubMed, Embase, and Web of Science databases were searched from inception to October 2020. Eligibility was restricted to studies reporting HER2/ErbB2 overexpression in histologically confirmed de novo SDC or SDC ex pleomorphic adenoma, with corresponding overall (OS) and disease-free (DFS) survival measures. Separate multivariable and univariable meta-analyses were performed using random-effects models. Statistical heterogeneity was estimated by Cochran's Q and I2 tests. Funnel plots were generated and Egger's test was used to assess for publication bias. The risk of bias was assessed with the Newcastle-Ottawa Scale. RESULTS Of 183 unique citations, 14 studies of 663 patients were included. Most included studies determined HER2 status according to ASCO/CAP guidelines. The univariable meta-analysis did not reveal an effect between HER2 status and OS (HR 1.09, 95% CI 0.84-1.42). In the multivariable analysis, HER2 positivity was associated with a HR of 1.49 for OS (95% CI 0.96-2.30). Fewer studies reported data for DFS than OS, with no relationship between HER2 status and DFS found on multivariable or univariable meta-analyses. CONCLUSION In patients with salivary duct carcinoma, HER2 positivity was not found to be associated with worse overall survival. This information may be useful when counseling patients and considering treatment options. Laryngoscope, 133:476-484, 2023.
Collapse
Affiliation(s)
| | - Adam T Townson
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Nancy Terry
- Division of Library Services, Office of Research Services, National Institutes of Health, Bethesda, Maryland, U.S.A
| | - Nicole C Schmitt
- Department of Otolaryngology, Head and Neck Surgery and Winship Cancer Institute, Emory University, Atlanta, Georgia, U.S.A
| | - Arun Sharma
- Department of Otolaryngology, Head and Neck Surgery, Southern Illinois University, Springfield, Illinois, U.S.A
| |
Collapse
|
16
|
Asper N, Roth KS, Hany TF, Salzberg SP, Tinguely M, Kadvany Y, Trojan A. Metastatic Salivary Duct Carcinoma with ERBB2 Amplification and Sequential Response to Ado-Trastuzumab Emtansine and Neratinib: A Case Report. Case Rep Oncol 2023; 16:1500-1507. [PMID: 38033416 PMCID: PMC10686627 DOI: 10.1159/000535097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Salivary duct carcinoma (SDC) is an aggressive and rare subtype of salivary gland carcinoma. Surgical excision and radiotherapy are standard of care for early cancer. Chemotherapies with taxanes and platinum show overall response rates between 39% and 50%. SDCs are often associated with an overexpression of the androgen receptor (AR) and HER2/neu which have recently become druggable targets. Case Presentation Here, we report on an 84-year-old male patient with metastatic SDC of the right parotid gland. In 2017, he underwent a right total parotidectomy, a right neck dissection, and an infratemporal fossa clearance followed by 6 weeks of radiotherapy. In 2018, due to metastatic spread in the lungs, bones, and pararenal gland, a pathological workup of the tumor tissue was performed and revealed both AR and HER2 overexpression, respectively. Consequently, he underwent androgen deprivation therapy and, due to asymptomatic progression, sequentially human epidermal growth factor receptor 2 (HER-2)-targeted therapy with ado-trastuzumab emtansine and neratinib, which led to stable disease during the course of about 18 months. The electronically captured patient-reported outcome had demonstrated a good tolerance of all three therapeutic lines. Conclusion In conclusion, since effective standard therapeutic treatment options for SDC may often not be tolerable in older patients, the implementation of personalized and adaptive treatments, especially in patients with rare tumor types, might offer valuable treatment options.
Collapse
Affiliation(s)
- Nora Asper
- University of Zurich, Zurich, Switzerland
| | | | | | | | | | | | | |
Collapse
|
17
|
Aizawa Y, Takada K, Aoyama J, Sano D, Yamanaka S, Seki M, Kuze Y, Ramilowski JA, Okuda R, Ueno Y, Nojima Y, Inayama Y, Hatakeyama H, Hatano T, Takahashi H, Nishimura G, Fujii S, Suzuki Y, Taniguchi H, Oridate N. Establishment of experimental salivary gland cancer models using organoid culture and patient-derived xenografting. Cell Oncol (Dordr) 2022; 46:409-421. [PMID: 36538240 DOI: 10.1007/s13402-022-00758-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Abstract
Purpose
Depending on its histological subtype, salivary gland carcinoma (SGC) may have a poor prognosis. Due to the scarcity of preclinical experimental models, its molecular biology has so far remained largely unknown, hampering the development of new treatment modalities for patients with these malignancies. The aim of this study was to generate experimental human SGC models of multiple histological subtypes using patient-derived xenograft (PDX) and organoid culture techniques.
Methods
Tumor specimens from surgically resected SGCs were processed for the preparation of PDXs and patient-derived organoids (PDOs). Specimens from SGC PDXs were also processed for PDX-derived organoid (PDXO) generation. In vivo tumorigenicity was assessed using orthotopic transplantation of SGC organoids. The pathological characteristics of each model were compared to those of the original tumors using immunohistochemistry. RNA-seq was used to analyze the genetic traits of our models.
Results
Three series of PDOs, PDXs and PDXOs of salivary duct carcinomas, one series of PDOs, PDXs and PDXOs of mucoepidermoid carcinomas and PDXs of myoepithelial carcinomas were successfully generated. We found that PDXs and orthotopic transplants from PDOs/PDXOs showed similar histological features as the original tumors. Our models also retained their genetic traits, i.e., transcription profiles, genomic variants and fusion genes of the corresponding histological subtypes.
Conclusion
We report the generation of SGC PDOs, PDXs and PDXOs of multiple histological subtypes, recapitulating the histological and genetical characteristics of the original tumors. These experimental SGC models may serve as a useful resource for the development of novel therapeutic strategies and for investigating the molecular mechanisms underlying the development of these malignancies.
Collapse
Affiliation(s)
- Yoshihiro Aizawa
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Kentaro Takada
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Jun Aoyama
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Daisuke Sano
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan.
| | - Shoji Yamanaka
- Department of Pathology, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Masahide Seki
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Chiba, Japan
| | - Yuta Kuze
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Chiba, Japan
| | | | - Ryo Okuda
- Roche Innovation Center, Roche Institute for Translational Bioengineering, Roche Pharma Research and Early Development, Basel, Switzerland
| | - Yasuharu Ueno
- Division of Regenerative Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, the University of Tokyo, Tokyo, Japan
| | - Yusuke Nojima
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Yoshiaki Inayama
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Hiromitsu Hatakeyama
- Department of Otolaryngology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Takashi Hatano
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Hideaki Takahashi
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Goshi Nishimura
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Satoshi Fujii
- Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Yutaka Suzuki
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Chiba, Japan
| | - Hideki Taniguchi
- Division of Regenerative Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, the University of Tokyo, Tokyo, Japan
| | - Nobuhiko Oridate
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| |
Collapse
|
18
|
Cleymaet R, Vermassen T, Coopman R, Vermeersch H, De Keukeleire S, Rottey S. The Therapeutic Landscape of Salivary Gland Malignancies-Where Are We Now? Int J Mol Sci 2022; 23:ijms232314891. [PMID: 36499216 PMCID: PMC9740091 DOI: 10.3390/ijms232314891] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
Salivary gland malignancies (SGMs) account for less than 5% of new diagnoses in head and neck tumors. If feasible, surgery is the preferred treatment modality. Nevertheless, some malignancies have a tendency of recurrence, with possible distant metastasis. Alternative treatment strategies, such as primary radiation or chemotherapeutics, often present low response rates. As a result, there is an unmet need for novel therapeutic approaches. Nowadays, target-based therapies (e.g., small inhibitors and immunotherapy) are used by the medical oncologist for possible treatment of advanced SGMs. Based on recent published trials, some novel treatments may provide additional disease control for some patients. However, sample sizes are small, the general findings are unsatisfactory, and a lot of uncertainties remain to be elucidated. Nevertheless, research shows that patients do not benefit from blind administration of systemic treatments and therefore a more personalized approach is highly needed. The aim of this review paper is to summarize the most recent advances in the biological understanding and molecular pathways of salivary gland cancers, the association of these pathways with the current treatments used and their implications for more personalized targeted-based therapies.
Collapse
Affiliation(s)
- Robbert Cleymaet
- Department of Oromaxillofacial and Plastic Surgery, Ghent University Hospital, 9000 Ghent, Belgium
| | - Tijl Vermassen
- Department Medical Oncology, University Hospital Ghent, 9000 Ghent, Belgium
- Department Basic and Applied Medical Sciences, Ghent University, 9000 Ghent, Belgium
- Cancer Research Institute Ghent, 9000 Ghent, Belgium
- Correspondence: ; Tel.: +32-9-332-26-92
| | - Renaat Coopman
- Department of Oromaxillofacial and Plastic Surgery, Ghent University Hospital, 9000 Ghent, Belgium
- Cancer Research Institute Ghent, 9000 Ghent, Belgium
| | - Hubert Vermeersch
- Department of Oromaxillofacial and Plastic Surgery, Ghent University Hospital, 9000 Ghent, Belgium
| | - Stijn De Keukeleire
- Department Internal Medicine, University Hospital Brussels, 1090 Brussels, Belgium
| | - Sylvie Rottey
- Department Medical Oncology, University Hospital Ghent, 9000 Ghent, Belgium
- Department Basic and Applied Medical Sciences, Ghent University, 9000 Ghent, Belgium
- Cancer Research Institute Ghent, 9000 Ghent, Belgium
- Drug Research Unit Ghent, University Hospital Ghent, 9000 Ghent, Belgium
| |
Collapse
|
19
|
Identification of novel prognostic and predictive biomarkers in salivary duct carcinoma via comprehensive molecular profiling. NPJ Precis Oncol 2022; 6:82. [PMCID: PMC9636405 DOI: 10.1038/s41698-022-00324-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
AbstractMolecular targets and predictive biomarkers for prognosis in salivary duct carcinoma (SDC) have not been fully identified. We conducted comprehensive molecular profiling to discover novel biomarkers for SDC. A total of 67 SDC samples were examined with DNA sequencing of 464 genes and transcriptome analysis in combination with the clinicopathological characteristics of the individuals. Prognostic biomarkers associated with response to combined androgen blockade (CAB) treatment were explored using mRNA expression data from 27 cases. Oncogenic mutations in receptor tyrosine kinase (RTK) genes or genes in the MAPK pathway were identified in 55 cases (82.1%). Alterations in the phosphatidylinositol 3-kinase (PI3K)/AKT signaling pathway were identified in 38 cases (56.7%). Interestingly, patient prognosis could be predicted using mRNA expression profiles, but not genetic mutation profiles. The risk score generated from the expression data of a four-gene set that includes the ADAMTS1, DSC1, RNF39, and IGLL5 genes was a significant prognostic marker for overall survival in the cohort (HR = 5.99, 95% confidence interval (CI) = 2.73–13.1, p = 7.8 × 10−6). Another risk score constructed from the expression of CD3E and LDB3 was a strong prognostic marker for progression-free survival for CAB treatment (p = 0.03). Mutations in RTK genes, MAPK pathway genes, and PI3K/AKT pathway genes likely represent key mutations in SDC tumorigenesis. The gene expression profiles identified in this study may be useful for stratifying patients who are good candidates for CAB treatment and may benefit from additional systemic therapies.
Collapse
|
20
|
Gazola AA, Wong D, Chin R, Nikitas J, Kim CJ, Hart SD, St John M, Chai-Ho W. Excellent Response to Fam-Trastuzumab Deruxtecan for Human Epidermal Growth Factor Receptor 2–Positive Salivary Duct Carcinoma With CNS Metastasis: A Case Report. JCO Precis Oncol 2022; 6:e2200399. [DOI: 10.1200/po.22.00399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Antonia Angeli Gazola
- School of Medicine, Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Deborah Wong
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Robert Chin
- Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - John Nikitas
- Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Christine J. Kim
- Department of Radiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Steven D. Hart
- Department of Pathology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Maie St John
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Wanxing Chai-Ho
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| |
Collapse
|
21
|
Kusafuka K, Sato Y, Nakatani E, Baba S, Maeda M, Yamanegi K, Ueda K, Inagaki H, Otsuki Y, Kuroda N, Suzuki K, Iwai H, Imamura Y, Itakura J, Yamanaka S, Takahashi H, Ito I, Akashi T, Daa T, Hamada M, Yasuda M, Kawata R, Yamamoto H, Tachibana Y, Fukuoka J, Muramatsu A, Arai K, Suzuki M. The implicated clinical factors for outcomes in 304 patients with salivary duct carcinoma: Multi-institutional retrospective analysis in Japan. Head Neck 2022; 44:1430-1441. [PMID: 35352425 PMCID: PMC9311811 DOI: 10.1002/hed.27034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 12/18/2021] [Accepted: 03/11/2022] [Indexed: 12/04/2022] Open
Abstract
Background Salivary duct carcinoma (SDC) is a high‐grade salivary malignancy that frequently occurs as the carcinomatous component of carcinoma ex pleomorphic adenoma. We herein examined the clinical factors affecting outcomes in a large cohort of SDC. Methods We selected 304 SDC cases and investigated clinical characteristics and the factors affecting outcomes. Results The median age of the cases examined was 68 years, the most common primary site was the parotid gland (238 cases), and there was a male predominance (M/F = 5:1). Outcomes were significantly worse when the primary tumor site was the minor salivary glands (SG) than when it was the major SG. Outcomes were also significantly worse in pN(+) cases (161 cases) than in pN0 cases, particularly those with a metastatic lymph node number ≥11. The cumulative incidence of relapse and distant metastases was significantly higher in stage IV cases than in stage 0–III cases. Conclusions The absolute number of lymph node metastases, higher stages, and the minor SG as the primary tumor site were identified as factors affecting the outcome of SDC.
Collapse
Affiliation(s)
| | - Yoko Sato
- Division of Clinical Biostatistics, Research Support Center, Shizuoka General Hospital, Shizuoka, Japan
| | - Eiji Nakatani
- Division of Clinical Biostatistics, Research Support Center, Shizuoka General Hospital, Shizuoka, Japan
| | - Satoshi Baba
- Department of Diagnostic Pathology, Hamamatsu University School of Medicine Hospital, Shizuoka, Japan
| | - Matsuyoshi Maeda
- Department of Clinical Pathology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Koji Yamanegi
- Department of Pathology, Hyogo Medical College, Hyogo, Japan
| | - Kaori Ueda
- Department of Pathology and Molecular Diagnostics, Nagoya City University, Nagoya, Japan
| | - Hiroshi Inagaki
- Department of Pathology and Molecular Diagnostics, Nagoya City University, Nagoya, Japan
| | - Yoshiro Otsuki
- Department of Pathology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
| | - Naoto Kuroda
- Department of Diagnostic Pathology, Kobe Koudou Hospital Center, Kobe, Japan
| | - Kensuke Suzuki
- Department of Otolaryngology - Head and Neck Surgery, Kansai Medical University, Osaka, Japan
| | - Hiroshi Iwai
- Department of Otolaryngology - Head and Neck Surgery, Kansai Medical University, Osaka, Japan
| | - Yoshiaki Imamura
- Division of Diagnostic Pathology/Surgical Pathology, University of Fukui Hospital, Fukui, Japan
| | - Junya Itakura
- Department of Anatomic Pathology, Kurashiki Central Hospital, Okayama, Japan
| | - Shoji Yamanaka
- Department of Diagnostic Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hideaki Takahashi
- Department of Otorhinolaryngology - Head and Neck Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ichiro Ito
- Department of Diagnostic Pathology, Nagano Red Cross Hospital, Nagano, Japan
| | - Takumi Akashi
- Division of Surgical Pathology, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Tsutomu Daa
- Department of Diagnostic Pathology, Oita University, Oita, Japan
| | - Mei Hamada
- Department of Diagnostic Pathology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masanori Yasuda
- Department of Diagnostic Pathology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Ryo Kawata
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | | | - Yuri Tachibana
- Department of Pathology, Nagasaki University, Nagasaki, Japan
| | - Junya Fukuoka
- Department of Pathology, Nagasaki University, Nagasaki, Japan
| | - Aya Muramatsu
- Department of Pathology, Shizuoka General Hospital, Shizuoka, Japan
| | - Kazumori Arai
- Department of Pathology, Shizuoka General Hospital, Shizuoka, Japan
| | - Makoto Suzuki
- Department of Pathology, Shizuoka General Hospital, Shizuoka, Japan
| |
Collapse
|
22
|
Tranchito E, Cabrera C, Terry M, Li S, Thuener JE, Fowler N, Lavertu P, Teknos TN, Rezaee RP, Tamaki A. Occult nodal metastasis in major salivary gland malignancy: An update from the National Cancer Database. Oral Oncol 2022; 128:105829. [PMID: 35349935 DOI: 10.1016/j.oraloncology.2022.105829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/13/2022] [Accepted: 03/19/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Malignant salivary gland tumors are rare neoplasms that are vastly heterogenous in their histological patterns and clinical behaviors. As a consequence, studies have lacked the robust sample sizes needed to define treatment strategies. In this study, we used the National Cancer Database to identify the incidence of occult nodal metastasis and effect on overall survival for the most common malignant salivary gland subtypes. A retrospective review of patients in the National Cancer Database with primary site malignancies of major salivary glands between 2004 and 2016 was performed. Subjects included in the study underwent surgical treatment with and without adjuvant radiation and had complete information on TNM pathological stage. MATERIALS AND METHODS 8,689 patients with primary malignant salivary gland cancer were analyzed. The sample was stratified by histologic subtype. Univariate analysis of lymph node metastasis of the whole cohort showed a higher risk of death (p < 0.001), when compared to those without. Also when comparing occult vs evident metastasis, the risk of death was higher for the latter (p < 0.001). RESULTS AND CONCLUSION Occult cervical lymph node metastasis ranged from 14.9% to 35.8% in malignant salivary gland cancers, depending on histological subtype. Occult nodal metastasis was a poor prognostic factor with significantly worse overall survival.
Collapse
Affiliation(s)
- Eve Tranchito
- Department of Otolaryngology- Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Claudia Cabrera
- Department of Otolaryngology- Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Morgan Terry
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Shawn Li
- Department of Otolaryngology- Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jason E Thuener
- Department of Otolaryngology- Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Nicole Fowler
- Department of Otolaryngology- Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Pierre Lavertu
- Department of Otolaryngology- Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Theodoros N Teknos
- Department of Otolaryngology- Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Rod P Rezaee
- Department of Otolaryngology- Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Akina Tamaki
- Department of Otolaryngology- Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| |
Collapse
|
23
|
Demography, patterns of care, and survival outcomes in patients with salivary duct carcinoma: an individual patient data analysis of 857 patients. Future Sci OA 2022; 8:FSO791. [PMID: 35369277 PMCID: PMC8965816 DOI: 10.2144/fsoa-2021-0052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 02/23/2022] [Indexed: 11/25/2022] Open
Abstract
Aim: Salivary duct carcinoma (SDC) is a rare and aggressive malignancy. The optimal treatment protocols are debated. Methodology: A systematic search and individual patient data analysis of published cases of SDC was performed. SPSS v21 was used for statistical analysis. Results: Data of 857 patients available. Median overall survival (OS) and progression-free survival (PFS) of the entire cohort 42 months and 24 months. Nodal involvement, males, primary size >5 cm, androgen receptor (AR) negativity significantly worse OS. Patients with surgery had a favorable median PFS (p = 0.000) and OS (p = 0.077). Patients with adjuvant radiation had better PFS (30 vs 18 months; p = 0.077). Conclusion: SDC has modest survival. Surgery and adjuvant radiation should be advocated for all patients. AR expression appears prognostic for survival. Salivary duct cancer (SDC) is a rare cancer. The exact care choices are debated. All published cases of SDC were pooled and analysis was carried out. Data from 857 patients were available. Median survival of the entire cohort was 42 months. Nodal involvement, males, large tumour, androgen receptor (AR) negativity worsened survival. Patients who underwent operation and radiation were better able to take care of illness. SDC has modest survival. Operation and radiation should be made available for all patients. AR expression changes survival results.
Collapse
|
24
|
Wakely PE. Salivary duct carcinoma: A report of 70 FNA cases and review of the literature. Cancer Cytopathol 2022; 130:595-608. [PMID: 35255198 DOI: 10.1002/cncy.22568] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/22/2022] [Accepted: 02/15/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although usually recognized as malignant, fine-needle aspiration (FNA) biopsy of salivary duct carcinoma (SDC) has been confused with other primary salivary gland (SG) neoplasms. This article undertook an analysis of a large collection of SDC FNA cases to assess diagnostic accuracy, specificity, and cytopathology. METHODS Cytopathology files were searched for SDC with histopathologic validation. FNA biopsy smears were performed using standard techniques. RESULTS Seventy cases from 56 patients (M:F, 1.9:1; age range, 26-92 years; mean age, 65 years) met inclusion criteria. All had tissue confirmation of SDC. FNA sites included: parotid gland (42, 60% cases), neck (10), submandibular gland (7), pre-/post-auricular area (5), face/cheek (3), mediastinal lymph nodes (2), and clavicle (1). Aspirates were from primary (52, 74%), metastatic (12, 17%), and locally recurrent (6, 9%) neoplasms. FNA diagnoses included: SDC (19, 27%), favor/suspicious for SDC (7, 10%), high-grade carcinoma (11), adenocarcinoma (9), carcinoma (6), malignant (6), SG neoplasm (5), atypia (3), SDC versus another malignancy (2), and pleomorphic adenoma (2). Large polygonal cells in groups and single forms showed cribriforming, variable necrosis, pseudopapillae, and oncocytic change. Androgen receptor staining was positive in all cases. CONCLUSIONS FNA biopsy is accurate and reliable in classifying SDC as a malignant neoplasm, but much less so for identification as a specific tumor type. Using the Milan system, 86% of aspirates were classified as either malignant or suspicious for malignancy. A recurring pitfall includes sampling error in cases of SDC ex pleomorphic adenoma.
Collapse
Affiliation(s)
- Paul E Wakely
- Department of Pathology, The Ohio State University Wexner Medical Center, James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| |
Collapse
|
25
|
Mueller SK, Haderlein M, Lettmaier S, Agaimy A, Haller F, Hecht M, Fietkau R, Iro H, Mantsopoulos K. Targeted Therapy, Chemotherapy, Immunotherapy and Novel Treatment Options for Different Subtypes of Salivary Gland Cancer. J Clin Med 2022; 11:720. [PMID: 35160172 PMCID: PMC8836387 DOI: 10.3390/jcm11030720] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 12/04/2022] Open
Abstract
Surgical resection remains the first line treatment for salivary gland cancer (SGC). In the case of locally advanced disease, surgery is followed by adjuvant radiotherapy. Surgical resection should be favored in resectable locoregional recurrent disease as well, and even the complete resection of all distant oligometastases has clinical benefit for the patients. For inoperable and disseminated metastatic disease, a multitude of systemic therapies including chemotherapy, targeted therapy, and immunotherapy are available. In this review, the current therapeutic options for inoperable recurrent or metastatic SGCs are summarized. Systemic treatment can achieve prolonged progression-free and overall survival, while the overall prognosis remains poor. Current clinical trials include only a limited number of patients and mostly combine different histologic subtypes. Additionally, no randomized controlled trial comparing different therapeutic options has been performed. In the future, further studies with a larger patient cohort and ideally only one histologic subtype are needed in order to improve the outcome for SGC patients. However, this may be difficult to accomplish due to the rarity and diversity of the disease. Additionally, molecular analyses need to be performed routinely in order to individualize treatment and to go one step further towards precision medicine.
Collapse
Affiliation(s)
- Sarina K. Mueller
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (H.I.); (K.M.)
- Working Group Salivary Glands and Thyroid Glands, Germany Otolaryngologic Society, Head and Neck Surgery, 53113 Bonn, Germany
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
| | - Marlen Haderlein
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Sebastian Lettmaier
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Abbas Agaimy
- Department of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.A.); (F.H.)
| | - Florian Haller
- Department of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.A.); (F.H.)
| | - Markus Hecht
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Rainer Fietkau
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Heinrich Iro
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (H.I.); (K.M.)
- Working Group Salivary Glands and Thyroid Glands, Germany Otolaryngologic Society, Head and Neck Surgery, 53113 Bonn, Germany
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
| | - Konstantinos Mantsopoulos
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (H.I.); (K.M.)
- Working Group Salivary Glands and Thyroid Glands, Germany Otolaryngologic Society, Head and Neck Surgery, 53113 Bonn, Germany
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
| |
Collapse
|
26
|
Kato T, Tsurukiri J, Sano H, Nagura T, Moriya M, Suenaga H, Matsunaga K, Kanemura T, Ueta Y, Arai T. Nonconvulsive Status Epilepticus Caused by Cerebrospinal Fluid Dissemination of a Salivary Duct Carcinoma: A Case Report. JMA J 2022; 5:151-156. [PMID: 35224282 PMCID: PMC8825421 DOI: 10.31662/jmaj.2021-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/21/2021] [Indexed: 11/09/2022] Open
Abstract
Salivary duct carcinoma (SDC) is a rare and highly aggressive salivary gland tumor with rapid growth, distant metastasis, and a high recurrence rate. Moreover, the parotid gland is the most common site with a poor prognosis. A lower frequency of distance metastasis to the liver, skin, and brain has also been reported, although the lungs, bones, and lymph nodes are the most common sites of SDC metastasis. We report a case of nonconvulsive status epilepticus (NCSE) in a 73-year-old male comatose patient having SDC of the parotid gland with an unusual metastasis to the skin and brain diagnosed by frequent cerebrospinal fluid examinations. Meningeal carcinomatosis usually has a poor prognosis, and NCSE is a reversible cause of altered mentation. Clinicians should know the unique set of epilepsy etiologies in patients with malignant tumors.
Collapse
Affiliation(s)
- Takahisa Kato
- Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Junya Tsurukiri
- Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Hidefumi Sano
- Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Takeo Nagura
- Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Mariko Moriya
- Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Hiroki Suenaga
- Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Kyosuke Matsunaga
- Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Takeshi Kanemura
- Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Yuki Ueta
- Department of Neurology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Takao Arai
- Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| |
Collapse
|
27
|
Yan F, Lao WP, Nguyen SA, Sharma AK, Day TA. Elective neck dissection in salivary gland malignancies: Systematic review and meta-analysis. Head Neck 2021; 44:505-517. [PMID: 34862810 DOI: 10.1002/hed.26923] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/25/2021] [Accepted: 10/26/2021] [Indexed: 12/27/2022] Open
Abstract
We defined the occult nodal metastasis (ONM) rate of clinical node-negative salivary gland malignancies and examined the role of elective neck dissection (END). Meta-analysis querying four databases, from inception of databases to March 25th, 2020. Fifty-one studies with 11 698 patients were included. ONM rates were 64% for salivary ductal carcinoma (SDC), 51% for undifferentiated carcinoma, 34% for carcinoma ex-pleomorphic adenoma (CXPA), 32% for adenocarcinoma not otherwise specified (ANOS), 31% for lymphoepithelial carcinoma (LE), 20% for mucoepidermoid carcinoma, 17% for acinic cell carcinoma, and 17% for adenoid cystic carcinoma. T3/T4 tumors had a 2.3 times increased risk of ONM than T1/T2 tumors. High-grade tumors had a 3.8 times increased risk of ONM than low/intermediate-grade tumors. ONM rates were exceedingly high for T3/T4, high-grade, and undifferentiated, SDC, ANOS, CXPA, and LE tumors, indicating the potential role of END.
Collapse
Affiliation(s)
- Flora Yan
- Department of Otolaryngology-Head and Neck Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Wilson P Lao
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, USA
| | - Shaun A Nguyen
- Head and Neck Tumor Center, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Anand K Sharma
- Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Terry A Day
- Head and Neck Tumor Center, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| |
Collapse
|
28
|
Shende N, Xu J, Li WT, Liu J, Chakladar J, Brumund KT, Ongkeko WM. Enhancer RNA Profiling in Smoking and HPV Associated HNSCC Reveals Associations to Key Oncogenes. Int J Mol Sci 2021; 22:12546. [PMID: 34830428 PMCID: PMC8625218 DOI: 10.3390/ijms222212546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/24/2021] [Accepted: 11/18/2021] [Indexed: 11/29/2022] Open
Abstract
Smoking and HPV infection are known causes for the vast majority of head and neck squamous cell carcinomas (HNSCC) due to their likelihood of causing gene dysregulation and genomic alterations. Enhancer RNAs (eRNAs) are non-coding RNAs that are known to increase nearby and target gene expression, and activity that has been suggested to be affected by genetic and epigenetic alterations. Here we sought to identify the effects of smoking and HPV status on eRNA expression in HNSCC tumors. We focused on four patient cohorts including smoking/HPV+, smoking/HPV-, non-smoking/HPV+, and non-smoking/HPV- patients. We used TCGA RNA-seq data from cancer tumors and adjacent normal tissue, extracted eRNA read counts, and correlated these to survival, clinical variables, immune infiltration, cancer pathways, and genomic alterations. We found a large number of differentially expressed eRNA in each patient cohort. We also found several dysregulated eRNA correlated to patient survival, clinical variables, immune pathways, and genomic alterations. Additionally, we were able to find dysregulated eRNA nearby seven key HNSCC-related oncogenes. For example, we found eRNA chr14:103272042-103272430 (eRNA-24036), which is located close to the TRAF3 gene to be differentially expressed and correlated with the pathologic N stage and immune cell populations. Using a separate validation dataset, we performed differential expression and immune infiltration analysis to validate our results from the TCGA data. Our findings may explain the association between eRNA expression, enhancer activity, and nearby gene dysregulation.
Collapse
Affiliation(s)
- Neil Shende
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California, San Diego, CA 92093, USA; (N.S.); (J.X.); (W.T.L.); (J.L.); (J.C.); (K.T.B.)
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Jingyue Xu
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California, San Diego, CA 92093, USA; (N.S.); (J.X.); (W.T.L.); (J.L.); (J.C.); (K.T.B.)
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Wei Tse Li
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California, San Diego, CA 92093, USA; (N.S.); (J.X.); (W.T.L.); (J.L.); (J.C.); (K.T.B.)
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Jeffrey Liu
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California, San Diego, CA 92093, USA; (N.S.); (J.X.); (W.T.L.); (J.L.); (J.C.); (K.T.B.)
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Jaideep Chakladar
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California, San Diego, CA 92093, USA; (N.S.); (J.X.); (W.T.L.); (J.L.); (J.C.); (K.T.B.)
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Kevin T. Brumund
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California, San Diego, CA 92093, USA; (N.S.); (J.X.); (W.T.L.); (J.L.); (J.C.); (K.T.B.)
- Department of Surgery, Division of Head and Neck Surgery, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Weg M. Ongkeko
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California, San Diego, CA 92093, USA; (N.S.); (J.X.); (W.T.L.); (J.L.); (J.C.); (K.T.B.)
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
| |
Collapse
|
29
|
Sousa LG, Wang K, Torman D, Binks BJ, Rubin ML, Andersen CR, Lewis WE, Rivera MJ, Kaya D, El-Naggar AK, Hanna EY, Esmaeli B, Frank SJ, Bell D, Glisson BS, Rodon J, Meric-Bernstam F, Lee JJ, Ferrarotto R. Treatment patterns and outcomes of palliative systemic therapy in patients with salivary duct carcinoma and adenocarcinoma, not otherwise specified. Cancer 2021; 128:509-518. [PMID: 34661906 DOI: 10.1002/cncr.33968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/16/2021] [Accepted: 09/15/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Salivary duct carcinoma (SDC) and adenocarcinoma, not otherwise specified (adeno-NOS), are rare salivary gland cancers. Data on the efficacy of systemic therapy for these diseases are limited. METHODS Data were retrospectively collected from patients seen at The University of Texas MD Anderson Cancer Center during 1990 to 2020. Objective response rate (ORR) was assessed per RECIST v1.1. Recurrence-free survival (RFS), progression-free survival (PFS), and overall survival (OS) were assessed by Kaplan-Meier method. Cox regression model was performed to identify predictors of survival. RESULTS The analysis included 200 patients (110 with SDC and 90 with adeno-NOS); 77% had androgen-receptor-positive tumors and 47% had HER2-positive (2+-3+) tumors. Most patients without metastasis at diagnosis underwent surgery (98%) and postoperative radiotherapy (87%). Recurrence rate was 55%, and the median RFS was 2 years. Nodal involvement and positive surgical margins were associated with recurrence (P < .005). Among patients with stage IVA-B disease, addition of systemic therapy to local therapy increased OS (P = .049). The most-used palliative-systemic-therapy regimen was platinum doublet ± trastuzumab. For first-line therapy, the ORR and median PFS were 33% and 5.76 months, respectively, and for second-line therapy the ORR and median PFS were 25% and 5.3 months, respectively. ORR and PFS were higher with HER2-targeting agents. Median OS was 5 years overall and 2 years for metastatic disease. Older age and higher stage were associated with worse OS. CONCLUSION Adding systemic therapy to local therapy may improve outcomes of patients with locoregionally advanced SDC or adeno-NOS. Except for HER2-targeted therapy, response to palliative systemic therapy is limited. These findings may be used as a benchmark for future drug development.
Collapse
Affiliation(s)
- Luana G Sousa
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kaiwen Wang
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Danice Torman
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Bailee J Binks
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Clark R Andersen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Whitney E Lewis
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Melvin J Rivera
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Diana Kaya
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adel K El-Naggar
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Bita Esmaeli
- Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Steven J Frank
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Diana Bell
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Bonnie S Glisson
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jordi Rodon
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - J Jack Lee
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Renata Ferrarotto
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
30
|
Kishi F, Matsuda R, Nakamura M, Nakagawa I, Motoyama Y. A case of brain metastasis from salivary duct carcinoma of the parotid gland. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2021.101108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
31
|
Almubarak AA, Alotaibi SK, Alghamdi FR, Alqahtani S, Alahmadi RM. Carcinosarcoma ex pleomorphic adenoma of the parotid gland: a case report. J Surg Case Rep 2021; 2021:rjab361. [PMID: 34422256 PMCID: PMC8376289 DOI: 10.1093/jscr/rjab361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/28/2021] [Indexed: 11/22/2022] Open
Abstract
Carcinosarcoma ex pleomorphic adenoma is an extremely rare malignant neoplasm of the salivary gland that originates from a pre-existing benign tumor. Malignant transformation of the pleomorphic adenoma is extremely rare. The management of carcinosarcoma ex pleomorphic adenoma remains challenging because of its rarity, behavioral aggressiveness and resemblance to benign pleomorphic adenoma. Herein, we present the case of a 75-year-old male resident of Saudi Arabia with a history of a swelling in the right parotid gland for more than 25 years, which grew slowly with time. He underwent surgical removal with superficial parotidectomy. Afterward, histological examination of the resected tumor revealed features of carcinosarcoma, and he was diagnosed with carcinosarcoma ex pleomorphic adenoma. He presented again with recurrence of the tumor, which was managed with total parotidectomy and a combination of radiotherapy and chemotherapy. At 12-month follow-up, the patient showed no evidence of disease recurrence or distant metastasis.
Collapse
Affiliation(s)
- Ali A Almubarak
- Department of Surgery, College of Medicine, King Saud bin Abdulziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Salman K Alotaibi
- Department of Surgery, College of Medicine, Shaqra University, Riyadh, Saudi Arabia
| | - Fareed R Alghamdi
- Department of Otolaryngology, Head & Neck Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Saeed Alqahtani
- Department of Otolaryngology, Head & Neck Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Rawan M Alahmadi
- Department of Otolaryngology, Head & Neck Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| |
Collapse
|
32
|
Chen SL, Yeh CJ, Chan KC. Salivary Duct Carcinoma in the External Auditory Canal Causing Ipsilateral Hearing Loss. Diagnostics (Basel) 2021; 11:diagnostics11081312. [PMID: 34441247 PMCID: PMC8391587 DOI: 10.3390/diagnostics11081312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Salivary duct carcinoma (SDC) is a rare aggressive tumor. Most tumors are not confined to the salivary ducts; rather, they invade the major and minor salivary glands. Only a few case reports on such tumors in other primary sites have appeared. Case presentation: A 40-year-old male complained of right hearing loss (a common condition), but we made an extremely rare diagnosis of an SDC in the external auditory canal (EAC). EAC cancers are frequently misdiagnosed. In our patient, the otoscope revealed a smooth, bulging subcutaneous lesion with a non-epithelial defect suggestive of a benign lesion. However, an SDC of the EAC was confirmed through pathological and immunohistochemical analysis. Conclusions: We suggest detailed evaluation of even smooth EAC subcutaneous lesions to avoid erroneous diagnoses. To the best of our knowledge, this is the first report of SDC in the EAC.
Collapse
Affiliation(s)
- Shih-Lung Chen
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou 333, Taiwan;
- School of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Chi-Ju Yeh
- School of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Pathology, Chang Gung Memorial Hospital, Linkou 333, Taiwan
| | - Kai-Chieh Chan
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou 333, Taiwan;
- School of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Otolaryngology, Chang Gung Memorial Hospital, Linkou 333, Taiwan
- Correspondence: ; Tel./Fax: +886-3-3979361
| |
Collapse
|
33
|
Fujimi A, Nagamachi Y, Yamauchi N, Nishisato T, Murase K, Takada K, Tsujiwaki M, Sugita S, Hasegawa T, Kato J. Eribulin in combination with HER2-targeted antibodies for successful treatment of metastatic salivary duct carcinoma: A report of two cases. Oral Oncol 2021; 120:105287. [PMID: 33858766 DOI: 10.1016/j.oraloncology.2021.105287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 03/31/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Akihito Fujimi
- Department of Hematology, Sapporo Kiyota Hospital, Japan.
| | | | | | | | - Kazuyuki Murase
- Department of Medical Oncology, Sapporo Medical University, Japan
| | - Kohichi Takada
- Department of Medical Oncology, Sapporo Medical University, Japan
| | | | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University, Japan
| | - Junji Kato
- Department of Medical Oncology, Sapporo Medical University, Japan
| |
Collapse
|
34
|
Abstract
Salivary gland diseases are rare. In the European Union (EU) a disease is considered to be rare if not more than 5 of 10,000 people are affected by it. According to estimates in Germany are about 4 million people with a rare disease. In the EU are about 30 million people with rare diseases [1]. In the present work most of the described diseases of salivary glands and of the facial nerve fall in this category. They form a very heterogeneous group whose treatment takes place mainly in specialized centers. Still, it is essential for the otolaryngologist to identify and to diagnose these diseases in order to initiate the right therapeutic steps. The work is a compilation of innate andacquired rare salivary gland disorders and of rare facial nerve disorders. The etiologies of inflammatory diseases, autoimmune disorders and tumors are taken into account. For the individual topics, the current literature, if available, was evaluated and turned into summarized facts. In this context the development of new processes, diagnostics, imaging and therapy are considered. Genetic backgrounds of salivary gland tumors and the trends in the treatment of tumorous lesions of the facial nerve are picked up. Furthermore, also rare diseases of the salivary glands in childhood are described. Some of them can occur in adults as well, but differ in frequency and symptoms. Due to the rarity of these diseases, it is recommended to tread these in centers with special expertise for it. Finally, the difficulties of initiation of studies and the problems of establishing disease registries concerning salivary gland disorders are discussed. This is very relevant because these pathologies are comparatively seldom.
Collapse
Affiliation(s)
- Claudia Scherl
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie,
Universitätsklinikum Mannheim
| |
Collapse
|
35
|
Luna-Ortiz K, Dominguez-Malagon H, Corredor-Alonso GE, Reynoso-Noveron N, Herrera-Ponzanelli C, Luna-Peteuil Z, Zacarias-Ramon LC. Clinicopathological and immunohistochemical behavior of ductal carcinoma of the salivary and lacrimal gland in a Mexican Mestizo population. Eur Arch Otorhinolaryngol 2021; 279:327-333. [PMID: 33763743 DOI: 10.1007/s00405-021-06757-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 03/13/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Salivary gland tumors are rare and include benign and malignant entities with different behavior and prognosis. Salivary gland carcinoma accounts for 0.2% of all cancers and 5-9% of head and neck carcinomas. We aim to describe the clinicopathological characteristics and discuss the immunohistochemical findings of salivary ductal carcinoma. METHODS We obtained 17 cases (2.3%) of salivary ductal carcinoma (SDC) from 727 patients with parotid tumors at our cancer center from a database covering a 22-year period (1996-2018). Two pathologists confirmed the diagnosis and excluded 6 cases. Eleven cases were assessed by immunohistochemistry (IHC) for HER2, estrogen receptor (ER), progesterone receptor (PR), androgen receptor (AR), mammaglobin, P53, GATA3, S100, cytokeratins (7,8,14,18, and 20), P63, PAX8, calponin, and SOX10. RESULTS Eleven SDC cases were in advanced stage, and 80% had metastasis. All cases were surgically treated, and 40% received different adjuvant chemotherapy regimens. we found that most patients were dead of disease. The histological and immunohistochemical analysis showed that 70% of cases were high-grade, 40% were positive for HER2, and 50% for AR. Moreover, a high Ki-67 proliferative index was detected in all cases. We observed luminal differentiation in 50% of cases. CONCLUSION SDC is a rare entity and survival is very poor. It is histologically similar to ductal carcinoma of the breast. However, important differences exist that help to distinguish them in case of synchronous cancers. The clinical behavior of SDC seems to be more aggressive and IHC analysis is useful for designing therapies.
Collapse
Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología (Mexico), Av San Fernando # 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico. .,Department of General Surgery (Head and Neck), Hospital Manuel Gea Gonzalez, Mexico City, Mexico.
| | - Hugo Dominguez-Malagon
- Department of Pathology, Instituto Nacional de Cancerología (Mexico), Av San Fernando # 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Guillermo E Corredor-Alonso
- Department of Pathology, Instituto Nacional de Cancerología (Mexico), Av San Fernando # 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Nancy Reynoso-Noveron
- Research Department at the Instituto Nacional de Cancerología (Mexico), Av San Fernando # 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Cesar Herrera-Ponzanelli
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología (Mexico), Av San Fernando # 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Zelik Luna-Peteuil
- General Medicine, Universitatea de Medicinâ si Farmacie Grigorie T. Popa IASI, Iasi, Romania
| | - Luis C Zacarias-Ramon
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología (Mexico), Av San Fernando # 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| |
Collapse
|
36
|
Hardy N, Thompson J, Mehra R, Drachenberg CB, Hatten K, Papadimitriou JC. Parotid Salivary Duct Carcinoma With a Prominent Squamous Component: Immunohistochemical Profile, Diagnostic Pitfalls, and Therapeutic Implications. Int J Surg Pathol 2021; 29:726-730. [PMID: 33683973 DOI: 10.1177/10668969211001952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Salivary duct carcinoma of the parotid gland is a highly aggressive epithelial malignancy morphologically resembling high-grade, invasive, and in situ breast carcinoma. It can occasionally present with variable morphology making it diagnostically challenging in cases with unusual morphological components. Ancillary testing, particularly androgen receptor (AR) positivity on immunohistochemistry, can be very helpful in cases that demonstrate extensive squamous morphology, since AR positivity is uncommon in both the primary salivary gland and metastatic squamous cell carcinomas to the parotid. In this report, we describe a case of salivary duct carcinoma that showed only a squamous cell carcinoma component on the initial primary tumor site biopsy, as well as in subsequent contralateral neck lymph node and skin metastases. Apart from the variable morphology, the typical salivary duct and squamous cell carcinoma tumor components also showed significant immunohistochemical differences, including differential staining of human epidermal growth factor receptor 2/neu. The associated diagnostic pitfalls, distinct immunoprofiles of the tumor components, helpful adjuncts for making the correct diagnosis, and associated therapeutic implications are discussed.
Collapse
Affiliation(s)
- Naomi Hardy
- 12264University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Ranee Mehra
- UM Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | | | - Kyle Hatten
- Otorhinolaryngology-Head & Neck Surgery, Baltimore, MD, USA
| | | |
Collapse
|
37
|
Sato T, Maeta T, Abe R, Yamada H, Ishida K, Yashima-Abo A, Kiyohara K, Miyajima S, Ito S. Successful Treatment with Nivolumab in a Patient with Metastatic Salivary Duct Carcinoma. Case Rep Oncol 2021; 14:343-346. [PMID: 33776727 PMCID: PMC7983598 DOI: 10.1159/000512060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 02/05/2023] Open
Abstract
Salivary duct carcinoma (SDC) is a rare and highly aggressive malignancy. A 58-year-old man presented with a right-sided submandibular mass and metastatic lesions in the right supraclavicular and inferior internal jugular nodes. He underwent right submandibulectomy and right neck dissection followed by adjuvant chemoradiotherapy. However, relapse occurred in the hilar lymph node and lumbar spine. Although radiotherapy was performed, a second relapse appeared in the hilar lymph nodes and sacral bone. Immunohistochemical analysis revealed negativity for programmed death ligand-1 (PD-L1) in the primary tumor specimen. The patient then received the anti-programmed death-1 (PD-1) antibody nivolumab. His metastatic lesions were completely eliminated after 48 weeks of therapy. This case reveals that anti-PD-1 antibodies are effective even against PD-L1-negative SDC.
Collapse
Affiliation(s)
- Tsuyoshi Sato
- Division of Hematology & Oncology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba, Japan
| | - Takahiro Maeta
- Division of Hematology & Oncology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba, Japan
| | - Ryosuke Abe
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Yahaba, Japan.,Department of Oral and Maxillofacial Surgery, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Hiroyuki Yamada
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Yahaba, Japan
| | - Kazuyuki Ishida
- Department of Diagnostic Pathology, Dokkyo Medical University, Mibu, Japan
| | - Akiko Yashima-Abo
- Department of Pathology, School of Medicine, Iwate Medical University, Yahaba, Japan
| | - Kazuki Kiyohara
- Division of Hematology & Oncology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba, Japan
| | - Shinri Miyajima
- Division of Hematology & Oncology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba, Japan
| | - Shigeki Ito
- Division of Hematology & Oncology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba, Japan
| |
Collapse
|
38
|
Palsgrove D, Allahabadi S, Khan SA. Genomic Analysis of Salivary Gland Cancer and Treatment of Salivary Gland Cancers. Surg Pathol Clin 2021; 14:151-163. [PMID: 33526219 DOI: 10.1016/j.path.2020.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Salivary gland cancer is a heterogenous group of tumors that presents challenges with both diagnosis and therapy. Recent advances in the classification of salivary gland cancers have led to distinct histologic and genomic criteria that successfully differentiate between cancers with similar clinical behavior and appearance. Genomic abnormalities have led to the emergence of targeted therapies being used in their therapy with drastic improvements in outcomes as well as reductions in treatment-related toxicity. Dramatic results seen with molecular targets, such as HER2, TRK, and others, indicate that this approach has the potential to yield even better treatments for the future.
Collapse
Affiliation(s)
- Doreen Palsgrove
- Department of Pathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Sameer Allahabadi
- Texas Christian University, University of North Texas Health Science Center School of Medicine, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107, USA
| | - Saad A Khan
- Stanford Cancer Institute and Stanford University, Stanford, CA, USA.
| |
Collapse
|
39
|
Suzuki T, Kano S, Suzuki M, Yasukawa S, Mizumachi T, Tsushima N, Hatanaka KC, Hatanaka Y, Matsuno Y, Homma A. Enhanced Angiogenesis in Salivary Duct Carcinoma Ex-Pleomorphic Adenoma. Front Oncol 2021; 10:603717. [PMID: 33692941 PMCID: PMC7937931 DOI: 10.3389/fonc.2020.603717] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/30/2020] [Indexed: 11/23/2022] Open
Abstract
Salivary duct carcinoma (SDC) is morphologically similar to breast cancer, with HER2-overexpression reported. With regard to the pattern of disease onset, SDC can arise from de novo or carcinoma ex-pleomorphic adenoma (Ca-ex-PA). Recently, multiple molecular profiles of SDC as well as breast cancer have been reported, with significant differences in HER2 expression between Ca-ex-PA and de novo. We assessed the differences in gene expression between onset classifications. We conducted immunohistochemical analysis and HER2-DISH for 23 patients and classified SDCs into three subtypes as follows: “HER2-positive” (HER2+/any AR), “Luminal-AR” (HER2-/AR+), and “Basal-like” (HER2-/AR-). We assessed the expression levels of 84 functional genes for 19 patients by using a qRT-PCR array. Ten cases were classified as HER2-positive, seven cases as Luminal-AR, and six cases as Basal-like. The gene expression pattern was generally consistent with the corresponding immunostaining classification. The expression levels of VEGFA, ERBB2(HER2), IGF1R, RB1, and XBP1 were higher, while those of SLIT2 and PTEN were lower in Ca-ex-PA than in de novo. The functions of those genes were concentrated in angiogenesis and AKT/PI3K signaling pathway (Fisher’s test: p-value = 0.025 and 0.004, respectively). Multiple machine learning methods, OPLS-DA, LASSO, and RandomForest, also show that VEGFA can be a candidate for the characteristic differences between Ca-ex-PA and de novo. In conclusion, the AKT/PI3K signaling pathway leading to angiogenesis was hyper-activated in all SDCs, particularly in those classified into the Ca-ex-PAs. VEGFA was over-expressed significantly in the Ca-ex-PA, which can be a crucial factor in the malignant conversion to SDC.
Collapse
Affiliation(s)
- Takayoshi Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Masanobu Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shinichiro Yasukawa
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takatsugu Mizumachi
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Nayuta Tsushima
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kanako C Hatanaka
- Clinical Research & Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan
| | - Yutaka Hatanaka
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - Yoshihiro Matsuno
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| |
Collapse
|
40
|
Choi SY, Lee E, Kim E, Chung MK, Son YI, Baek CH, Jeong HS. Clinical outcomes of bulky parotid gland cancers: need for self-examination and screening program for early diagnosis of parotid tumors. BMC Cancer 2021; 21:178. [PMID: 33602169 PMCID: PMC7890841 DOI: 10.1186/s12885-021-07902-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 02/11/2021] [Indexed: 01/15/2023] Open
Abstract
Background Early detection and diagnosis of parotid gland cancer (PGC) are essential to improve clinical outcomes, because Tumor-Node-Metastasis stage at diagnosis is a very strong indicator of prognosis in PGC. Nevertheless, some patients still present with large parotid mass, maybe due to the unawareness or ignorance of their disease. In this study, we aimed to present the clinical outcomes of bulky PGC (defined by a 4 cm cutoff point for T3–4 versus T1–2 tumors), to emphasize the necessity of a self-examination tool for parotid gland tumor. Methods We retrospectively reviewed 60 consecutive cases with bulky (equal to and greater than 4 cm in the longest diameter, determined radiologically) malignant tumors arising from the parotid gland from 1995 to 2016. The clinical and pathological factors were analyzed to identify risk factors for poor outcomes using Cox proportional hazard models. In addition, we designed a self-examination tool for parotid gland tumors, similar to breast self-examination for breast cancer detection. Results Patients with bulky parotid cancer showed 48.9% 5-year and 24.5% 10-year overall survival rates and a 47.9% risk of high-grade malignancy. The common pathological diagnoses were carcinoma ex pleomorphic adenoma (18.3%), adenocarcinoma (16.7%), mucoepidermoid carcinoma (16.7%), salivary duct carcinoma (16.7%), and adenoid cystic carcinoma (11.7%). Survival analyses revealed that tumor size (hazard ratio, HR = 1.262 upon increase of 1 cm, 95% confidence interval, 95%CI 1.059–1.502), lymph node metastasis (HR = 2.999, 95%CI 1.048–8.583), and high tumor grade (HR = 4.148, 95%CI 1.215–14.154) were independent prognostic factors in multivariable analysis. Functional preservation of the facial nerve was possible only in less than half of patients. Conclusion In bulky PGC, lymph node metastasis at diagnosis and high tumor grade indicated poor survival outcomes, and functional outcomes of the facial nerve were suboptimal. Thus, a public effort seems to be necessary to decrease these patients with bulky PGC, and to increase patients’ self-awareness of their disease. As a way of early detection, we proposed a parotid self-examination tool to detect parotid gland tumors at an early stage, which is similar to breast self-examination. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-07902-9.
Collapse
Affiliation(s)
- Sung Yong Choi
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eunkyu Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eunhye Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young-Ik Son
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chung-Hwan Baek
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Han-Sin Jeong
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
41
|
Schvartsman G, Bell D, Rubin ML, Tetzlaff M, Hanna E, Lee JKJ, Weber R, Phan J, Glisson BS, Ferrarotto R. The tumor immune contexture of salivary duct carcinoma. Head Neck 2021; 43:1213-1219. [PMID: 33576119 DOI: 10.1002/hed.26587] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 10/28/2020] [Accepted: 12/08/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Salivary duct carcinoma (SDC) is a rare and aggressive malignancy. Recently, biomarker studies found promising targetable alterations. In this study, we provide a descriptive analysis of tumor and immune biomarkers and survival associations. METHODS We extracted clinical data and performed immunohistochemistry for AR, AR-V7, HER-2, PD-L1, LAG-3, and tumor-infiltrating immune cells. RESULTS We included 17 patients. Age ranged from 42 to 85 years old; HER-2 was overexpressed or amplified in 65%. AR was positive in 88% of patients, while AR-V7 was positive in 13% by IHC. We found low scores of immune infiltration and a PD-L1 expression in 53%. We found no clinically significant association between biomarkers and survival outcomes. CONCLUSION In this small series of SDC, biomarkers do not seem to correlate with disease biology, although they provide additional treatment options. SDC may harbor a different immune profile compared to other subtypes, with an indication of T-cell dysfunction.
Collapse
Affiliation(s)
- Gustavo Schvartsman
- Department of Medical Oncology, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Diana Bell
- Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Maria Laura Rubin
- Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Michael Tetzlaff
- Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Ehab Hanna
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Jiun-Kae Jack Lee
- Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Randal Weber
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Jack Phan
- Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Bonnie S Glisson
- Department of Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Renata Ferrarotto
- Department of Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
42
|
Adjuvant therapy in the management of operable salivary duct carcinoma: correlating evidence with a retrospective review. JOURNAL OF RADIOTHERAPY IN PRACTICE 2021. [DOI: 10.1017/s1460396920001259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Abstract
Background:
Salivary duct carcinoma (SDC) is an extremely rare and aggressive subtype of salivary gland cancer with high morbidity and mortality and poor response to treatment. The current options of treatment include radical surgery followed by radiotherapy (RT) with or without chemotherapy. The aim of this study was to analyse the patterns of recurrences, possible predictors of outcome and role of RT in a cohort of patients with non-metastatic SDC.
Methods:
A retrospective review of patients treated between 2010 and 2019 with histologically proven non-metastatic SDC was conducted.
Results:
Sixteen patients were included in the series. Median follow-up was 25 months. Progression-free survival (PFS) and overall survival (OS) at 12 months were 61% and 80%, respectively. Seven out of the 16 patients had disease progression, distant metastases being most frequent. Four patients died due to disease progression. PFS was significantly worse for patients with pathological neck node positivity (p = 0·036) and peri-parotid nodes (p = 0·007). Local control was significantly associated with RT (p = 0·011). Addition of any chemotherapy, regardless of either concurrent or adjuvant, had no impact on the PFS or OS. Pathological neck node positivity with nodal stage of N2 or higher correlated significantly with worse OS (p = 0·031).
Conclusion:
Salivary ductal carcinoma is an aggressive malignancy with high metastatic potential. Inferior prognosis was observed among patients who had metastatic deposits in either cervical nodes or peri-parotid nodes on histopathology. As systemic failures are more predominant among these patients, larger prospective trials are needed to formulate an optimum strategy for choice and sequencing of first-line systemic therapy.
Collapse
|
43
|
Joshi NP, Broughman JR. Postoperative Management of Salivary Gland Tumors. Curr Treat Options Oncol 2021; 22:23. [PMID: 33560478 DOI: 10.1007/s11864-021-00820-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 12/26/2022]
Abstract
OPINION STATEMENT Salivary gland tumors represent a heterogeneous group of neoplasms characterized by varied histologies and disease outcomes. Initial treatment for the primary and gross nodal disease is usually surgery. Management of the clinically node-negative neck depends upon the risk of lymph nodal involvement. This is usually determined by the AJCC "T" stage and histology. Both surgery and radiation may be utilized to address the lymph nodes at risk. This is especially important for minor salivary gland tumors. Radiation plays an important role in the adjuvant management of salivary gland tumors by reducing the risk of locoregional recurrence. Certain histologies like adenoid cystic carcinoma have a predilection for neurotropic spread to the skull base. Radiation is particularly important in controlling disease at the skull base. The role of concurrent chemotherapy in the adjuvant treatment of salivary gland tumors is not established and remains an area of active research. Certain histologies like salivary duct carcinoma exhibit readily identifiable molecular targets amenable to targeted therapy. Finally, advanced testing of these tumors using next-generation sequencing can also potentially identify molecular targets amenable to therapy. While useful in the management of metastatic disease, the role of these therapies in the adjuvant setting remains unknown.
Collapse
Affiliation(s)
- Nikhil P Joshi
- Department of Radiation Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - James R Broughman
- Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, USA
| |
Collapse
|
44
|
Rahman M, Griffith CC. Salivary Duct Carcinoma: An Aggressive Salivary Gland Carcinoma with Morphologic Variants, Newly Identified Molecular Characteristics, and Emerging Treatment Modalities. Surg Pathol Clin 2021; 14:111-126. [PMID: 33526216 DOI: 10.1016/j.path.2020.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Salivary duct carcinoma (SDC) is a rare, aggressive salivary gland malignancy with significant mortality. Morphologically, most tumors are characterized by apocrine differentiation with a typical immunophenotype of androgen receptor positive/gross cystic disease fluid protein positive/estrogen receptor negative/progesterone receptor negative. Several morphologic variants of SDC exist, representing diagnostic pitfalls. Several differential diagnoses should be considered because prognosis, treatment, and management may be different from SDC. For SDC, current treatment strategies are aggressive and commonly include surgical excision with lymph node dissection and adjuvant radiotherapy. Continued research is examining the utility of androgen deprivation therapy and targeted molecular therapy.
Collapse
Affiliation(s)
- Mobeen Rahman
- The Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA; Cleveland Clinic Head and Neck Pathology, Mail Code L25, 9500 Euclid Avenue, Cleveland, OH 44195, USA. https://twitter.com/ENT_path
| | - Christopher C Griffith
- The Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA; Cleveland Clinic Head and Neck Pathology, Mail Code L25, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
| |
Collapse
|
45
|
Chatzopoulos K, Collins AR, Sotiriou S, Keeney MG, Visscher DW, Rivera M, Schembri-Wismayer DJ, Lewis JE, Greipp PT, Sukov WR, Chintakuntlawar AV, Price KA, Garcia JJ. Increased ERBB2 Gene Copy Numbers Reveal a Subset of Salivary Duct Carcinomas with High Densities of Tumor Infiltrating Lymphocytes and PD-L1 Expression. Head Neck Pathol 2020; 14:951-965. [PMID: 32350809 PMCID: PMC7669929 DOI: 10.1007/s12105-020-01163-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/22/2020] [Indexed: 02/08/2023]
Abstract
Salivary duct carcinoma (SDC) commonly expresses androgen receptor (AR) and HER2, giving rise to treatment implications. SDC may also express programmed-death-ligand-1 (PD-L1), a predictive marker of response to checkpoint inhibitors. PD-L1 can be associated with genomic instability and high density of tumor infiltrating lymphocytes (TILs). Evaluation of HER2 immunohistochemistry (IHC) in SDC is not standardized, and relationships between ERBB2 copy numbers, PD-L1 expression and TILs in SDC are unknown. We evaluated 32 SDCs for HER2, AR and PD-L1 expression (IHC), ERBB2 status (FISH) and TILs (slide review). HER2 was scored with three different systems (breast, gastric, proposed salivary gland). PD-L1 was evaluated with the combined positive score. Most patients were older men, presenting at advanced clinical stage with nodal or distant metastases. During follow-up (mean 5 years, range 6 months to 21 years), 25 of the 32 patients (78%) died of SDC. We propose a HER2 IHC scoring system which accurately predicts underlying ERBB2 amplification or increased copy numbers in SDC. Most tumors had increased ERBB2 copy numbers (19/32 amplification, 6/32 aneusomy), a finding associated with higher TIL densities (p = 0.045) and PD-L1 expression (p = 0.025). Patients with TILs ≥ 40% had better prognoses (Log-Rank p = 0.013), with TILs being favorable prognosticators in univariate analysis (Hazard ratio: 0.18, p = 0.024). A subset of SDCs with increased ERBB2 copy numbers have higher TILs and PD-L1 expression. TILs ≥ 40% are associated with better prognosis.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- B7-H1 Antigen/biosynthesis
- Biomarkers, Tumor/analysis
- Carcinoma, Ductal/genetics
- Carcinoma, Ductal/immunology
- Carcinoma, Ductal/pathology
- DNA Copy Number Variations
- Female
- Gene Amplification
- Genes, erbB-2
- Humans
- Lymphocytes, Tumor-Infiltrating/immunology
- Lymphocytes, Tumor-Infiltrating/pathology
- Male
- Middle Aged
- Receptor, ErbB-2/genetics
- Receptor, ErbB-2/metabolism
- Salivary Gland Neoplasms/genetics
- Salivary Gland Neoplasms/immunology
- Salivary Gland Neoplasms/pathology
Collapse
Affiliation(s)
| | | | - Sotiris Sotiriou
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Michael G. Keeney
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Daniel W. Visscher
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Michael Rivera
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | | | - Jean E. Lewis
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Patricia T. Greipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - William R. Sukov
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | | | | | - Joaquin J. Garcia
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
- Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 USA
| |
Collapse
|
46
|
Katsakhyan L, LiVolsi VA, Chalian AA, Zhang PJ. Giant Cell Carcinosarcoma of the Parotid Gland With a PLAG 1 Translocation in Association With a Pleomorphic Adenoma With HMGA2 Translocation. Am J Clin Pathol 2020; 154:811-815. [PMID: 32814949 DOI: 10.1093/ajcp/aqaa104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Carcinosarcomas of the salivary gland are rare neoplasms and have been described arising de novo or in association with pleomorphic adenoma (PA). PLAG1 and HMGA2 translocations are known to occur in PAs and carcinomas ex PA but are mutually exclusive. METHODS We report a case of a carcinosarcoma in the parotid gland of a 77-year-old man with unusual anaplastic sarcomatoid giant cell morphology. RESULTS Microscopically, a small separate PA was found adjacent to the carcinosarcoma. By conventional notion, the PA and carcinosarcoma would be considered related, as carcinosarcomas are well known to arise from PAs (carcinosarcoma ex PA). However, fluorescence in situ hybridization (FISH) assay demonstrated PLAG1 translocation in the carcinosarcoma and HMGA2 translocation in the separate PA. CONCLUSIONS These findings support that the carcinosarcoma likely originated from another PA with a PLAG1 translocation or de novo but not from the coexisting PA harboring a different translocation. To our knowledge, the case is the first to demonstrate PLAG1 translocation by FISH in a sarcomatous component of any parotid gland tumor, which may help better classify these tumors. In addition, multiple PAs are commonly found in the salivary gland, and to our knowledge, our case is the first to demonstrate that the same parotid gland can host PAs and PA-related tumors with different translocations.
Collapse
Affiliation(s)
- Levon Katsakhyan
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia
| | - Virginia A LiVolsi
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia
| | - Ara A Chalian
- Department of Otorhinolaryngology, Hospital of the University of Pennsylvania, Philadelphia
| | - Paul J Zhang
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia
| |
Collapse
|
47
|
Combined androgen deprivation therapy in recurrent androgen-receptor-positive salivary duct carcinoma – a case report and review of the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:599-603. [DOI: 10.1016/j.jormas.2019.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 12/27/2019] [Indexed: 12/12/2022]
|
48
|
Ran J, Zou H, Li X, Guo F, Xu W, Han W. A population-based competing risk survival analysis of patients with salivary duct carcinoma. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1355. [PMID: 33313100 PMCID: PMC7723556 DOI: 10.21037/atm-20-1849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Salivary duct carcinoma (SDC) is a rare malignancy with high risk of local recurrence and distant metastases of the salivary gland. This study was designed to summarize the clinical and pathological features and to further evaluate them as potential prognostic factors for SDC in the salivary gland. Methods Clinical data of 266 patients diagnosed with SDC between 2004 and 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. The prognostic factors affecting overall survival (OS) and cancer-specific survival (CSS) were determined by Kaplan-Meier analyses and Cox proportional hazards model. The nomogram was established to predict OS and CSS for SDC. The predictive accuracy of the nomograms was measured by concordance index (C-index). Results The 3- and 5-year OS of SDC patients were 67.41% and 47.86%, while the 3- and 5-year CSS were 84.6% and 60.7%, respectively. The primary site, T stage and M stage were identified as independent prognostic factors for OS by the multivariate analysis, whereas N stage, M stage, the presence of multiple primary carcinomas and the treatment modalities were identified as independent prognostic factors for CSS. The C-index values of the prognostic nomogram based the risk factors affecting SDC OS and CSS were 0.703 (0.646–0.760) and 0.771 (0.691–0.851), respectively. Conclusions SDC is an aggressive malignancy with a high proportion of advanced stage and lymph node metastases. Patients with increasing age, submandibular gland malignancy, advanced T stage, advanced N stage, advanced M stage, high lymph node ratio (LNR) and the presence of multiple primary carcinomas tend to have unfavorable outcomes. Radiotherapy or chemotherapy improve CSS remarkably. These factors will aid in effective therapeutic treatment modalities for SDC.
Collapse
Affiliation(s)
- Jianchuan Ran
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Huihui Zou
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xiaoye Li
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Feng Guo
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wenguang Xu
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wei Han
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| |
Collapse
|
49
|
Porcheri C, Meisel CT, Mitsiadis TA. Molecular and Cellular Modelling of Salivary Gland Tumors Open New Landscapes in Diagnosis and Treatment. Cancers (Basel) 2020; 12:E3107. [PMID: 33114321 PMCID: PMC7690880 DOI: 10.3390/cancers12113107] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023] Open
Abstract
Salivary gland tumors are neoplasms affecting the major and minor salivary glands of the oral cavity. Their complex pathological appearance and overlapping morphological features between subtypes, pose major challenges in the identification, classification, and staging of the tumor. Recently developed techniques of three-dimensional culture and organotypic modelling provide useful platforms for the clinical and biological characterization of these malignancies. Additionally, new advances in genetic and molecular screenings allow precise diagnosis and monitoring of tumor progression. Finally, novel therapeutic tools with increased efficiency and accuracy are emerging. In this review, we summarize the most common salivary gland neoplasms and provide an overview of the state-of-the-art tools to model, diagnose, and treat salivary gland tumors.
Collapse
Affiliation(s)
- Cristina Porcheri
- Orofacial Development and Regeneration, Institute of Oral Biology, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (C.T.M.); (T.A.M.)
| | | | | |
Collapse
|
50
|
Yang ZY, Huang JH, Chen B, Xu CW, Lei L, Wang XJ, Fang MY. Efficacy of Pyrotinib in HER2-Overexpressing Salivary Duct Carcinoma With Lung Metastasis: A Case Report. Front Oncol 2020; 10:559057. [PMID: 33123470 PMCID: PMC7567027 DOI: 10.3389/fonc.2020.559057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/27/2020] [Indexed: 12/27/2022] Open
Abstract
Background: Salivary duct carcinoma (SDC), an aggressive and rare malignancy with poor prognosis, is mostly associated with the overexpression of the androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2). However, limited data are available for the targeting of both HER2 and AR in advanced/metastatic SDC. Case Presentation: A 62-year-old man with advanced SDC accompanied by lung and lymph node metastasis showed disease progression after two lines of chemotherapy and endocrine therapy. Metastatic lesions from the lung biopsy were obtained, and immunohistochemistry (IHC) indicated the overexpression of AR and HER2 (3+). The patient was administered pyrotinib (a pan-ErbB receptor tyrosine kinase inhibitor) and bicalutamide (an androgen receptor antagonist) as a third-line treatment. During the ten months of follow-up, a durable partial response was achieved with this combination. Conclusions: This is the first clinical study to report the successful application of pyrotinib in a patient with advanced SDC. We recommend that pyrotinib and bicalutamide be used as salvage therapy for AR and HER2-positive advanced metastases in SDC, given the favorable response and clinical benefit.
Collapse
Affiliation(s)
- Zi-Yan Yang
- Department of Breast Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China.,Department of Oncology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Jia-Huan Huang
- Department of Breast Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China
| | - Bo Chen
- Department of Pathology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - Chun-Wei Xu
- Department of Respiratory, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lei Lei
- Department of Breast Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China
| | - Xiao-Jia Wang
- Department of Breast Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China
| | - Mei-Yu Fang
- Department of General Oncology, Key Laboratory of Head and Neck Cancer Translational Research of Zhejiang Province, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China
| |
Collapse
|