title: Significant and durable clinical benefit from trastuzumab in 2 patients with HER2-amplified salivary gland cancer and a review of the literature.
abstract: Salivary ductal carcinoma and carcinoma ex pleomorphic adenoma (CEPA) are aggressive salivary gland cancers with poor prognosis. The standard of care is resection with or without radiotherapy, and there are no established systemic therapy options.
  
  
  
  We describe 1 patient with metastatic CEPA and 1 patient with metastatic recurrent salivary duct carcinoma whose tumors were evaluated by comprehensive genomic profiling. Testing identified human epidermal growth factor receptor 2 (HER2) amplification in both patients, and an additional activating HER2 mutation in the CEPA case.
  
  
  
  Both patients were treated with the HER2-targeting monoclonal antibody trastuzumab (herceptin) plus chemotherapy and experienced rapid responses. Subsequently, both patients were given single-agent maintenance trastuzumab and continue to experience durable disease control.
  
  
  
  Given the poor prognosis for salivary gland cancers and the limited treatment options upon recurrence or metastasis, patients should be tested for all classes of HER2 alterations. In cases with HER2 overexpression or activation, targeted therapies, such as trastuzumab are promising. © 2016 Wiley Periodicals, Inc. Head Neck 39: E40-E44, 2017.
authors.affiliation: Foundation Medicine Inc, Cambridge, Massachusetts.
authors.forename: Lauren M
authors.identifier: 0000-0002-5302-9136
authors.initials: LM
authors.lastname: Thorpe
authors.affiliation: Foundation Medicine Inc, Cambridge, Massachusetts.
authors.forename: Alexa B
authors.initials: AB
authors.lastname: Schrock
authors.affiliation: Foundation Medicine Inc, Cambridge, Massachusetts.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Erlich
authors.affiliation: Foundation Medicine Inc, Cambridge, Massachusetts.
authors.forename: Vincent A
authors.initials: VA
authors.lastname: Miller
authors.affiliation: Illinois Cancer Care, Peoria, Illinois.
authors.forename: James
authors.initials: J
authors.lastname: Knost
authors.affiliation: Illinois Cancer Care, Peoria, Illinois.
authors.forename: Nguyet
authors.initials: N
authors.lastname: Le-Lindqwister
authors.affiliation: Illinois Cancer Care, Peoria, Illinois.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Jujjavarapu
authors.affiliation: Foundation Medicine Inc, Cambridge, Massachusetts.
authors.forename: Siraj M
authors.initials: SM
authors.lastname: Ali
authors.affiliation: Illinois Cancer Care, Peoria, Illinois.
authors.forename: Jane J
authors.initials: JJ
authors.lastname: Liu
mesh_terms: D008949:Adenoma, Pleomorphic / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001707:Biopsy, Needle; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D058990:Molecular Targeted Therapy / Q000379:methods*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000187:drug effects* / Q000235:genetics*; D018570:Risk Assessment; D012468:Salivary Gland Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D000068878:Trastuzumab / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human
keywords: comprehensive genomic profiling; human epidermal receptor 2 (HER2); salivary gland cancer; targeted therapy; trastuzumab