title: [Durable remission under dual HER2 blockade with Trastuzumab and Pertuzumab in a patient with metastatic gallbladder cancer].
abstract: Gallbladder cancer represents a rare but dismal disease. The only curative option is complete surgical resection, though patients often develop recurrent disease. In patients with advanced biliary tract cancer, the combination of cisplatin and gemcitabine showed a benefit in overall survival compared to gemcitabine alone. However, there is no standardized second-line regimen after treatment failure. We report on a young patient with early recurrence of a gallbladder cancer with cutaneous and peritoneal metastases. Upon identification of an ERBB2 gene amplification within the NCT MASTER (Molecularly Aided Stratification for Tumor Eradication Research) exome sequencing program with resulting overexpression of HER2 in the tumors cells, the patient received a targeted therapy with the HER2 antibodies pertuzumab and trastuzumab in combination with nab-paclitaxel, which led to a durable remission for more than one year. This case report underlines the potential of molecularly aided personalized targeted therapy for patients with biliary tract cancer and the need for respective clinical trials.
authors.affiliation: Universitätsklinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Abteilung Medizinische Onkologie * Sektion Personalisierte Onkologie.
authors.forename: E
authors.initials: E
authors.lastname: Czink
authors.affiliation: Nationales Centrum für Tumorerkrankungen und Deutsches Krebsforschungszentrum (DKFZ), Abteilung Translationale Onkologie.
authors.forename: C
authors.initials: C
authors.lastname: Heining
authors.affiliation: Universitätsklinikum Heidelberg, Abteilung Diagnostische und Interventionelle Radiologie.
authors.forename: T F
authors.initials: TF
authors.lastname: Weber
authors.affiliation: Universitätsklinikum Heidelberg, Pathologisches Institut.
authors.forename: F
authors.initials: F
authors.lastname: Lasitschka
authors.affiliation: Universitätsklinikum Heidelberg, Abteilung für Allgemein-, Viszeral- & Transplantationschirurgie.
authors.forename: P
authors.initials: P
authors.lastname: Schemmer
authors.affiliation: Universitätsklinikum Heidelberg, Pathologisches Institut.
authors.forename: P
authors.initials: P
authors.lastname: Schirmacher
authors.affiliation: Universitätsklinikum Heidelberg, Abteilung Gastroenterologie, Infektionskrankheiten, Vergiftungen.
authors.forename: K H
authors.initials: KH
authors.lastname: Weiss
authors.affiliation: Nationales Centrum für Tumorerkrankungen und Deutsches Krebsforschungszentrum (DKFZ), Abteilung Translationale Onkologie.
authors.forename: H
authors.initials: H
authors.lastname: Glimm
authors.affiliation: Deutsches Krebsforschungszentrum (DKFZ), Abteilung Angewandte Bioinformatik.
authors.forename: B
authors.initials: B
authors.lastname: Brors
authors.affiliation: Universitätsklinikum Heidelberg, Pathologisches Institut.
authors.forename: W
authors.initials: W
authors.lastname: Weichert
authors.affiliation: Universitätsklinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Abteilung Medizinische Onkologie * Sektion Personalisierte Onkologie.
authors.forename: D
authors.initials: D
authors.lastname: Jäger
authors.affiliation: Nationales Centrum für Tumorerkrankungen und Deutsches Krebsforschungszentrum (DKFZ), Abteilung Translationale Onkologie.
authors.forename: S
authors.initials: S
authors.lastname: Fröhling
authors.affiliation: Universitätsklinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Abteilung Medizinische Onkologie * Sektion Personalisierte Onkologie.
authors.forename: C
authors.initials: C
authors.lastname: Springfeld
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary*; D005260:Female; D005706:Gallbladder Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D058990:Molecular Targeted Therapy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000037:antagonists & inhibitors*; D012074:Remission Induction / Q000379:methods; D000068878:Trastuzumab / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human; C485206:pertuzumab