title: HER2 blockade in metastatic collecting duct carcinoma (CDC) of the kidney: a case report.
abstract: BACKGROUND
  Collecting duct carcinoma of the kidney (CDC) is a rare cancer associated with bad prognosis and, at present, with no specific effective therapies.
  
  
  METHODS
  We report a clinical case with disseminated highgrade CDC presenting with widespread metastasis to both lungs, pelvic bones, axial skeleton, and the central nervous system (posterior fossa, both hemispheres and pituitary-hypothalamic). The primary tumor in the kidney was demonstrated (by fluorescence in situ hybridization and immunohistochemistry with Herceptest (3+ score)) to significantly overexpress HER2. Critically ill at presentation, the patient received oral capecitabine together with double HER2 blockade with both intravenous trastuzumab and oral lapatinib. His clinical response was a dramatic improvement and a progressive decline in the radiological size of all of his multiple cancer lesions.
  
  
  CONCLUSIONS
  Double HER2 blockade is an effective therapy in disseminated CDC even in the presence of brain metastases.
authors.affiliation: Department of Oncology, Hospital of Mollet, Barcelona, Spain. mhbronchud@telefonica.net
authors.forename: Miguel H
authors.initials: MH
authors.lastname: Bronchud
authors.forename: Sergi
authors.initials: S
authors.lastname: Castillo
authors.forename: Santiago
authors.initials: S
authors.lastname: Escriva de Romaní
authors.forename: Santiago
authors.initials: S
authors.lastname: Mourelo
authors.forename: Alejandra
authors.initials: A
authors.lastname: Fernández
authors.forename: Cecilia
authors.initials: C
authors.lastname: Baena
authors.forename: Jesús
authors.initials: J
authors.lastname: Murillo
authors.forename: Joan C
authors.initials: JC
authors.lastname: Julia
authors.forename: Jordi
authors.initials: J
authors.lastname: Esquius
authors.forename: Rubén
authors.initials: R
authors.lastname: Romero
authors.forename: Xavier
authors.initials: X
authors.lastname: Andreu
mesh_terms: D000284:Administration, Oral; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001932:Brain Neoplasms / Q000517:prevention & control* / Q000556:secondary*; D000069287:Capecitabine; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D007275:Injections, Intravenous; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000077341:Lapatinib; D008297:Male; D011799:Quinazolines / Q000008:administration & dosage; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000037:antagonists & inhibitors*; D000068878:Trastuzumab; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000069287:Capecitabine; D003841:Deoxycytidine; D005472:Fluorouracil; D000077341:Lapatinib; D011799:Quinazolines; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human