title: Cetuximab in the treatment of metastatic mucoepidermoid carcinoma of the salivary glands: a case report and review of literature.
abstract: BACKGROUND
  Patients with metastatic mucoepidermoid carcinoma of salivary glands have a poor outcome. The epidermal growth factor receptor protein is overexpressed in approximately 70% of mucoepidermoid carcinoma patients and may represent a therapeutic target. However, whether treatment with anti-epidermal growth factor receptor agents is effective is unclear and clinical trials are difficult due to the rarity of the disease. Here we assessed the activity of cetuximab in mucoepidermoid carcinoma on a molecular basis.
  
  
  METHODS
  We present the case of a 40-year old Caucasian man with a mucoepidermoid carcinoma of the major salivary glands who developed distant bone and visceral metastases despite platinum-based chemotherapy. Epidermal growth factor receptor was overexpressed and fluorescence in situ hybridization analysis demonstrated a chromosome 7 polysomy. The patient was treated with the monoclonal antibody cetuximab in combination with cisplatin. After 11 doses of cetuximab, the patient developed brain metastases but evidence of response was documented at all extracranial metastatic sites.
  
  
  CONCLUSIONS
  This case report indicates that cetuximab can be active in mucoepidermoid carcinoma and may restore sensitivity to cisplatin in platinum-treated patients. Cetuximab does not cross the blood brain barrier and may select a metastatic clone to home the central nervous system while responding at other sites.
authors.affiliation: Department of Medical Oncology, Azienda Spedali Civili, Brescia, Italy. salvatore.grisanti@tin.it
authors.forename: Salvatore
authors.initials: S
authors.lastname: Grisanti
authors.forename: Vito
authors.initials: V
authors.lastname: Amoroso
authors.forename: Michela
authors.initials: M
authors.lastname: Buglione
authors.forename: Anna
authors.initials: A
authors.lastname: Rosati
authors.forename: Roberto
authors.initials: R
authors.lastname: Gatta
authors.forename: Claudio
authors.initials: C
authors.lastname: Pizzocaro
authors.forename: Vittorio D
authors.initials: VD
authors.lastname: Ferrari
authors.forename: Giovanni
authors.initials: G
authors.lastname: Marini