title: Human epidermal receptor 2-amplified salivary duct carcinoma: regression with dual human epidermal receptor 2 inhibition and anti-vascular endothelial growth factor combination treatment.
abstract: BACKGROUND
  Salivary ductal carcinoma is a rare cancer with poor prognosis and limited treatment options. Human epidermal receptor 2 (HER2)-directed treatment has been attempted in HER2-amplified or overexpressed salivary gland malignancies with limited success.
  
  
  METHODS
  We report resolution of measurable disease and minimal residual disease in a patient with salivary duct cancer treated with trastuzumab, lapatinib, and bevacizumab, with treatment ongoing for more than 2 years.
  
  
  RESULTS
  This treatment has been tolerated well except for grade 2 diarrhea and mucositis, which required a dose reduction of lapatinib to 1000 mg daily. The response observed was achieved in spite of receiving extensive prior therapy, including trastuzumab and/or chemotherapy for 20 months on which his tumors progressed.
  
  
  CONCLUSIONS
  The combination of trastuzumab, lapatinib, and bevacizumab may warrant investigation as a non-cytotoxic alternative for treatment of HER2-amplified or overexpressed salivary duct carcinoma and other HER2-amplified or overexpressed salivary gland tumors, particularly those not responsive to trastuzumab monotherapy.
authors.affiliation: Department of Investigational Cancer Therapeutics, (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Falchook
authors.forename: Scott M
authors.initials: SM
authors.lastname: Lippman
authors.forename: Christel C
authors.initials: CC
authors.lastname: Bastida
authors.forename: Razelle
authors.initials: R
authors.lastname: Kurzrock
mesh_terms: D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000378:metabolism / Q000627:therapeutic use*; D000068258:Bevacizumab; D004359:Drug Therapy, Combination; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D000077341:Lapatinib; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D011799:Quinazolines / Q000008:administration & dosage / Q000627:therapeutic use*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D018987:Salivary Ducts; D012468:Salivary Gland Neoplasms / Q000188:drug therapy* / Q000378:metabolism*; D000068878:Trastuzumab; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068258:Bevacizumab; D000077341:Lapatinib; D011799:Quinazolines; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; D042461:Vascular Endothelial Growth Factor A; C508053:ERBB2 protein, human
keywords: bevacizumab; human epidermal receptor 2 (HER2); lapatinib; salivary duct carcinoma; trastuzumab