Salivary duct carcinoma treated with cetuximab-based targeted therapy: A case report

Kawahara,Kenta; Hiraki,Akimitsu; Yoshida,Ryoji; Arita,Hidetaka; Matsuoka,Yuichiro; Yamashita,Toshio; Koga,Kan‑Ichi; Nagata,Masashi; Hirosue,Akiyuki; Fukuma,Daiki; Nakayama,Hideki

doi:10.3892/mco.2017.1226

Salivary duct carcinoma treated with cetuximab-based targeted therapy: A case report

Authors:
- Kenta Kawahara
- Akimitsu Hiraki
- Ryoji Yoshida
- Hidetaka Arita
- Yuichiro Matsuoka
- Toshio Yamashita
- Kan‑Ichi Koga
- Masashi Nagata
- Akiyuki Hirosue
- Daiki Fukuma
- Hideki Nakayama
View Affiliations

Affiliations: Department of Oral and Maxillofacial Surgery, Sensory and Motor Organ Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto 860‑8556, Japan, Division of Oral Oncology, Department of Oral and Maxillofacial Surgery, Fukuoka Dental College, Fukuoka 814‑0193, Japan, Department of Oral and Maxillofacial Surgery, Amakusa Central General Hospital, Amakusa, Kumamoto 863‑0033, Japan
Published online on: April 21, 2017 https://doi.org/10.3892/mco.2017.1226
Pages: 886-892

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Salivary duct carcinoma is a highly aggressive disease with a poor prognosis. Surgical resection is currently the only curative treatment, as there is no effective systemic therapy for this malignancy. Recently, trastuzumab has been shown to exhibit therapeutic efficacy in the treatment of salivary duct carcinoma; similarly, molecularly targeted agents, such as cetuximab, are expected to be useful for salivary duct carcinoma treatment. We herein describe the case of a 56-year-old man diagnosed with salivary duct carcinoma in the left submandibular region, with ipsilateral multiple metastases to the neck lymph nodes. Radical resection of the tumor and submandibular gland with neck dissection were performed. One month after radical surgery, computed tomography (CT) scans indicated metastasis in the lower lobe of the left lung. CT‑guided transthoracic fine‑needle aspiration biopsy revealed a single metastasis and lung metastasectomy was immediately performed. The tumor cells of the primary lesion and those of the lung metastasis were immunohistochemically positive for epidermal growth factor receptor. One month later, multiple right lung metastases appeared, and the patient was treated with cisplatin/5‑fluorouracil (5‑FU) chemotherapy plus cetuximab, achieving a complete radiographic response. However, multiple lung metastases developed during adjuvant weekly cetuximab monotherapy. Subsequently, treatment with S‑1 and weekly cetuximab was initiated, and the multiple lung metastases have been maintained as stable disease for 5 months. To the best of our knowledge, this is the first report of cetuximab use for the treatment of salivary duct carcinoma. Although cisplatin/5‑FU chemotherapy plus cetuximab was efficacious in treating the lung metastasis, cetuximab monotherapy was insufficient for controlling tumor growth.

View Figures

View References

1	Gal R, Strauss M, Zohar Y and Kessler E: Salivary duct carcinoma of the parotid gland. Cytologic and histopathologic study. Acta Cytol. 29:454–456. 1985.PubMed/NCBI
2	Jaehne M, Roeser K, Jaekel T, Schepers JD, Albert N and Löning T: Clinical and immunohistologic typing of salivary duct carcinoma: A report of 50 cases. Cancer. 103:2526–2533. 2005. View Article : Google Scholar : PubMed/NCBI
3	Seifert G, Batsakis J, Brocheriou C, Cardesa A, Dardick I and Ellis G: World Health Organization. Histological typing of salivary gland tumors. 2nd. New York: Springer; 1991, View Article : Google Scholar
4	Seifert G and Caselitz J: Epithelial salivary gland tumors: Tumor markersFenoglio-Preiser CM, Wolff M and Rilke F: Progress in surgical pathology. New York: Field & Wood; pp. 157–187. 1989, View Article : Google Scholar
5	Barnes L, Eveson J, Reichart P and Sidranksky D: World Health Organization Classification of TumoursPathology and genetics of head and neck tumours. Lyon: IARC Press; pp. 236–237. 2005
6	McHugh JB, Visscher DW and Barnes EL: Update on selected salivary gland neoplasms. Arch Pathol Lab Med. 133:1763–1774. 2009.PubMed/NCBI
7	Shinoto M, Shioyama Y, Nakamura K, Nakashima T, Kunitake N, Higaki Y, Sasaki T, Ohga S, Yoshitake T, Ohnishi K, et al: Postoperative radiotherapy in patients with salivary duct carcinoma: Clinical outcomes and prognostic factors. J Radiat Res. 54:925–930. 2013. View Article : Google Scholar : PubMed/NCBI
8	Kim JY, Lee S, Cho KJ, Kim SY, Nam SY, Choi SH, Roh JL, Choi EK, Kim JH, Song SY, et al: Treatment results of post-operative radiotherapy in patients with salivary duct carcinoma of the major salivary glands. Br J Radiol. 85:e947–e952. 2012. View Article : Google Scholar : PubMed/NCBI
9	Johnston ML, Huang SH, Waldron JN, Atenafu EG, Chan K, Cummings BJ, Gilbert RW, Goldstein D, Gullane PJ, Irish JC, et al: Salivary duct carcinoma: Treatment, outcomes, and patterns of failure. Head Neck. 8 Suppl 1:E820–E826. 2016. View Article : Google Scholar
10	Salovaara E, Hakala O, Bäck L, Koivunen P, Saarilahti K, Passador-Santos F, Leivo I and Mäkitie AA: Management and outcome of salivary duct carcinoma in major salivary glands. Eur Arch Otorhinolaryngol. 270:281–285. 2013. View Article : Google Scholar : PubMed/NCBI
11	Weon YC, Park SW, Kim HJ, Jeong HS, Ko YH, Park IS, Kim ST, Baek CH and Son YI: Salivary duct carcinomas: Clinical and CT and MR imaging features in 20 patients. Neuroradiology. 54:631–640. 2012. View Article : Google Scholar : PubMed/NCBI
12	Roh JL, Cho KJ, Kwon GY, Choi SH, Nam SY and Kim SY: Prognostic values of pathologic findings and hypoxia markers in 21 patients with salivary duct carcinoma. J Surg Oncol. 97:596–600. 2008. View Article : Google Scholar : PubMed/NCBI
13	Falchook GS, Lippman SM, Bastida CC and Kurzrock R: Human epidermal receptor 2-amplified salivary duct carcinoma: Regression with dual human epidermal receptor 2 inhibition and anti-vascular endothelial growth factor combination treatment. Head Neck. 36:E25–E27. 2014. View Article : Google Scholar : PubMed/NCBI
14	Xie S, Yang H, Bredell M, Shen S, Yang H, Jin L and Zhang S: Salivary duct carcinoma of the parotid gland: A case report and review of the literature. Oncol Lett. 9:371–374. 2015.PubMed/NCBI
15	Lee JS, Kwon OJ, Park JJ and Seo JH: Salivary duct carcinoma of the parotid gland: Is adjuvant HER-2-targeted therapy required? J Oral Maxillofac Surg. 72:1023–1031. 2014. View Article : Google Scholar : PubMed/NCBI
16	Limaye SA, Posner MR, Krane JF, Fonfria M, Lorch JH, Dillon DA, Shreenivas AV, Tishler RB and Haddad RI: Trastuzumab for the treatment of salivary duct carcinoma. Oncologist. 18:294–300. 2013. View Article : Google Scholar : PubMed/NCBI
17	Fan CY, Melhem MF, Hosal AS, Grandis JR and Barnes EL: Expression of androgen receptor, epidermal growth factor receptor, and transforming growth factor alpha in salivary duct carcinoma. Arch Otolaryngol Head Neck Surg. 127:1075–1079. 2001. View Article : Google Scholar : PubMed/NCBI
18	Williams MD, Roberts D, Blumenschein GR Jr, Temam S, Kies MS, Rosenthal DI, Weber RS and El-Naggar AK: Differential expression of hormonal and growth factor receptors in salivary duct carcinomas: Biologic significance and potential role in therapeutic stratification of patients. Am J Surg Path. 31:1645–1652. 2007. View Article : Google Scholar : PubMed/NCBI
19	Williams MD, Roberts DB, Kies MS, Mao L, Weber RS and El-Naggar AK: Genetic and expression analysis of HER-2 and EGFR genes in salivary duct carcinoma: Empirical and therapeutic significance. Clin Cancer Res. 16:2266–2274. 2010. View Article : Google Scholar : PubMed/NCBI
20	Locati LD, Bossi P, Perrone F, Potepan P, Crippa F, Mariani L, Casieri P, Orsenigo M, Losa M, Bergamini C, et al: Cetuximab in recurrent and/or metastatic salivary gland carcinomas: A phase II study. Oral Oncol. 45:574–578. 2009. View Article : Google Scholar : PubMed/NCBI
21	Seifert G, Brocheriou C, Cardesa A and Eveson JW: WHO International histological classification of tumours. Tentative histological classification of salivary gland tumours. Pathol Res Pract. 186:555–581. 1990. View Article : Google Scholar : PubMed/NCBI
22	Vermorken JB, Mesia R, Rivera F, Remenar E, Kawecki A, Rottey S, Rottey S, Erfan J, Zabolotnyy D, Kienzer HR, et al: Platinum-based chemotherapy plus cetuximab in head and neck cancer. New Engl J Med. 359:1116–1127. 2008. View Article : Google Scholar : PubMed/NCBI
23	Guo Y, Shi M, Yang A, Feng J, Zhu X, Choi YJ, Hu G, Pan J, Hu C, Luo R, et al: Platinum-based chemotherapy plus cetuximab first-line for Asian patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck: Results of an open-label, single-arm, multicenter trial. Head Neck. 37:1081–1087. 2015. View Article : Google Scholar : PubMed/NCBI
24	Tsukahara K, Kubota A, Hasegawa Y, Takemura H, Terada T, Taguchi T, Nagahara K, Nakatani H, Yoshino K, Higaki Y, et al: Randomized phase III trial of adjuvant chemotherapy with S-1 after curative treatment in patients with squamous-cell carcinoma of the head and neck (ACTS-HNC). PLoS One. 10:e01169652015. View Article : Google Scholar : PubMed/NCBI
25	Kleinsasser O, Klein HJ and Hubner G: Salivary duct carcinoma. A group of salivary gland tumors analogous to mammary duct carcinoma. Arch Klin Exp Ohren Nasen Kehlkopfheilkd. 192:100–105. 1968.(In German). View Article : Google Scholar : PubMed/NCBI
26	Adelstein DJ, Koyfman SA, El-Naggar AK and Hanna EY: Biology and management of salivary gland cancers. Semin Radiat Oncol. 22:245–253. 2012. View Article : Google Scholar : PubMed/NCBI
27	Barnes L, Rao U, Krause J, Contis L, Schwartz A and Scalamogna P: Salivary duct carcinoma. Part I. A clinicopathologic evaluation and DNA image analysis of 13 cases with review of the literature. Oral Surg Oral Med Oral Pathol. 78:64–73. 1994. View Article : Google Scholar : PubMed/NCBI
28	Guzzo M, Di Palma S, Grandi C and Molinari R: Salivary duct carcinoma: Clinical characteristics and treatment strategies. Head Neck. 19:126–133. 1997. View Article : Google Scholar : PubMed/NCBI
29	Airoldi M, Fornari G, Pedani F, Marchionatti S, Gabriele P, Succo G and Bumma C: Paclitaxel and carboplatin for recurrent salivary gland malignancies. Anticancer Res. 20:3781–3783. 2000.PubMed/NCBI
30	Surakanti SG and Agulnik M: Salivary gland malignancies: The role for chemotherapy and molecular targeted agents. Semin Oncol. 35:309–319. 2008. View Article : Google Scholar : PubMed/NCBI
31	Dimery IW, Legha SS, Shirinian M and Hong WK: Fluorouracil, doxorubicin, cyclophosphamide, and cisplatin combination chemotherapy in advanced or recurrent salivary gland carcinoma. J Clin Oncol. 8:1056–1062. 1990. View Article : Google Scholar : PubMed/NCBI
32	Lagha A, Chraiet N, Ayadi M, Krimi S, Allani B, Rifi H, Raies H and Mezlini A: Systemic therapy in the management of metastatic or advanced salivary gland cancers. Oral Oncol. 48:948–957. 2012. View Article : Google Scholar : PubMed/NCBI
33	Bobbio A, Copelli C, Ampollini L, Bianchi B, Carbognani P, Bettati S, Sesenna E and Rusca M: Lung metastasis resection of adenoid cystic carcinoma of salivary glands. Eur J Cardiothorac Surg. 33:790–793. 2008. View Article : Google Scholar : PubMed/NCBI
34	Liu D, Labow DM, Dang N, Martini N, Bains M, Burt M, Downey R Jr, Rusch V, Shah J and Ginsberg RJ: Pulmonary metastasectomy for head and neck cancers. Ann Surg Oncol. 6:572–578. 1999. View Article : Google Scholar : PubMed/NCBI
35	Kaidar-Person O, Billan S and Kuten A: Targeted therapy with trastuzumab for advanced salivary ductal carcinoma: Case report and literature review. Med Oncol. 29:704–706. 2012. View Article : Google Scholar : PubMed/NCBI
36	Nabili V, Tan JW, Bhuta S, Sercarz JA and Head CS: Salivary duct carcinoma: A clinical and histologic review with implications for trastuzumab therapy. Head Neck. 29:907–912. 2007. View Article : Google Scholar : PubMed/NCBI
37	Prat A, Parera M, Reyes V, Peralta S, Cedrés S, Andreu J, Huguet P and del Campo JM: Successful treatment of pulmonary metastatic salivary ductal carcinoma with trastuzumab-based therapy. Head Neck. 30:680–683. 2008. View Article : Google Scholar : PubMed/NCBI
38	Ettl T, Stiegler C, Zeitler K, Agaimy A, Zenk J, Reichert TE, Gosau M, Kühnel T, Brockhoff G and Schwarz S: EGFR, HER2, survivin, and loss of pSTAT3 characterize high-grade malignancy in salivary gland cancer with impact on prognosis. Hum Pathol. 43:921–931. 2012. View Article : Google Scholar : PubMed/NCBI
39	Ito FA, Ito K, Coletta RD, Graner E, de Almeida OP and Lopes MA: Salivary gland tumors: Immunohistochemical study of EGF EGFR, ErbB-2, FAS and Ki-67. Anal Quant Cytol Histol. 31:280–287. 2009.PubMed/NCBI