Cutaneous lymphangitis carcinomatosa in salivary duct carcinoma

Uijen, Maike J M; Weijers, Jetty Anne Mina; Lassche, Gerben; Ravensteijn, Stefan G. van; Rijk, Maartje C. van; Lubeek, Satish FK; Grunsven, Adriana CH van Engen-van; Amir, Avital L.; Driessen, Chantal; Herpen, Carla M. van

doi:10.1136/jcp-2022-208564

Cited by 2 publications

(6 citation statements)

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“…Thus, further development of HER2-targeted therapy and ADT as systemic therapy in these patients, as well as in patients with breast, stomach, and prostate cancer, is warranted. 10,12 To date, the efficacy of pertuzumab, 24,25,43 ado-trastuzumab emtansine, [25][26][27]43 and trastuzumab deruxtecan 28 as a HER2-targeted therapy, and the efficacy of receiving abiraterone 32 and enzalutamide 33 as an ADT have been evaluated. Furthermore, HER2-targeted therapy and ADT are also expected to have a role as adjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the application of these biomarkers in clinical practice should be investigated in the future. 10,12,36,37,47,48,51 To our knowledge, this was the largest study to investigate the clinical outcomes of LA/RM patients with SDC with a confirmed diagnosis of SDC based on a central pathology review. However, this study had some limitations.…”

Section: Therapeutic Advances Inmentioning

confidence: 99%

“…However, as results from randomized phase III studies comparing HER2-targeted therapy or ADT to conventional therapy are not available, because of the rarity of SDC, the superiority of HER2-targeted therapy or ADT over conventional therapy remains controversial. 10,36,37 The latest NCCN guidelines mentioned that there are no preferred regimens. 34 The ASCO guidelines also described that no single-agent or combination therapy has been shown to have a survival advantage, and there are no randomized trials comparing treatment with supportive care alone.…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Although systemic therapy has been developed for metastatic SGC, its efficacy remains unclear. 7,[10][11][12] The overall response rate (ORR) of combination therapy with platinum and taxane for metastatic SDC was 40-50%, and the median OS in Japanese studies was 10-20 months. [13][14][15] Recently, the efficacy of immune checkpoint inhibitors (ICIs) has been shown in SGC cases; however, its efficacy in patients with SDC has not been fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

“…4,19,20 The efficacy and safety of HER2-targeted therapy and androgen deprivation therapy (ADT) in patients with locally advanced (LA) and/or recurrent or metastatic (RM) SDC, in accordance with the treatment strategies for HER2-positive breast cancer and AR-positive prostate cancer, have been evaluated in prospective and retrospective studies (Table 1). 6,[21][22][23][24][25][26][27][28][29][30][31][32][33] These therapies are recommended by the latest National Comprehensive Cancer Network (NCCN) 34 and American Society for Clinical Oncology (ASCO) 35 guidelines. However, as results from randomized phase III studies comparing HER2-targeted therapy or ADT to conventional therapy are not available, because of the rarity of SDC, the superiority of HER2-targeted therapy or ADT over conventional therapy remains controversial.…”

Section: Introductionmentioning

confidence: 99%

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Survival benefit of HER2-targeted or androgen deprivation therapy in salivary duct carcinoma

et al. 2022

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Background: The efficacy and safety of human epidermal growth factor receptor 2 (HER2)-targeted therapy and androgen deprivation therapy (ADT) for locally advanced or recurrent or metastatic (LA/RM) salivary duct carcinoma (SDC) have been reported in prospective studies. However, the survival benefit of these therapies to conventional therapy remains controversial, and whether HER2-targeted therapy or ADT should be chosen in HER2- and androgen receptor (AR)-positive SDC patients remains unknown. Methods: Overall, 323 LA/RM SDC patients treated at seven institutions between August 1992 and June 2020 were retrospectively enrolled. The primary aim was to analyze the effect of HER2-targeted therapy and ADT on overall survival from the diagnosis of LA/RM disease to death from any cause (OS1). The secondary indicators included the overall response rate (ORR), clinical benefit rate (CBR), overall survival from therapy initiation for LA/RM disease (OS2), progression-free survival (PFS), time to second progression (PFS2), duration of response (DoR), and duration of clinical benefit (DoCB) of HER2-targeted therapy or ADT as first-line therapy for HER2-positive/AR-positive SDC. Results: Patients treated with HER2-targeted therapy or ADT had longer OS1 than those treated without these therapies (Median OS1: historical control, 21.6 months; HER2-targeted therapy, 50.6 months; ADT, 32.8 months; HER2-targeted therapy followed by ADT, 42.4 months; and ADT followed by HER2-targeted therapy, 45.2 months, p < 0.001). Among HER2-positive/AR-positive SDC patients, although HER2-targeted therapy had better ORR, CBR, and PFS than those of ADT as first-line therapy, we found no significant differences between HER2-targeted therapy and ADT regarding OS2, PFS2, DoR, and DoCB. Conclusion: Patients treated with HER2-targeted therapy and ADT showed longer survival in LA/RM SDC. HER2-targeted therapy can be recommended prior to ADT for HER2-positive/AR-positive SDC. It is warranted to establish a biomarker that could predict the efficacy of clinical benefit or better response in ADT.

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