We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The Benefits of Adjuvant Trastuzumab for HER‐2‐Positive Salivary Gland Cancers.
- Authors
Hanna, Glenn J.; Bae, Ji Eun; Lorch, Jochen H.; Haddad, Robert I.; Jo, Vickie Y.; Schoenfeld, Jonathan D.; Margalit, Danielle N.; Tishler, Roy B.; Goguen, Laura A.; Annino, Donald J.; Chau, Nicole G.
- Abstract
Background: Although high‐grade salivary gland cancers (SGCs) often express androgen receptor (AR) and/or HER‐2/neu, therapeutically targeting these receptors in SGC remains investigational. We investigated the prevalence of receptor expression and the benefit of adjuvant HER‐2 directed therapy in the high‐risk postoperative setting and explored the clinical utility of sequentially targeting these receptors in the setting of advanced disease. Materials and Methods: We clinically annotated 95 patients with SGC (excluding adenoid cystic carcinoma) treated at our institution from 2002 to 2019 and recorded AR, HER‐2/neu status, and tumor genomic profiling results when available. Clinicopathologic information was then integrated with outcomes. Results: Of 95 patients, most had high‐risk histologies, with salivary duct carcinoma (SDC) as the most frequent diagnosis (43, 45%). Thirty‐five (37%) experienced recurrence (51% SDC). HER‐2/neu was positive (1–3+) by immunostaining in 34 of 52 (65%) evaluable cases. There was no difference in survival based on HER‐2/neu or AR expression. Nine of 17 (53%) patients with HER‐2+ SDC received adjuvant chemoradiation with trastuzumab. Median disease‐free survival (DFS) and overall survival (OS) were longer among patients with HER‐2/neu 3+ staining tumors who received adjuvant trastuzumab versus those who did not (DFS, 117 vs. 9 months; p =.02; OS, 74 vs. 43 months; p =.02), with no difference among other HER‐2/neu subgroups (0–2+). Two of nine (22%) patients treated with adjuvant trastuzumab demonstrated recurrence, both with low HER‐2/neu staining intensity (1+). Longer time to recurrence (hazard ratio, 0.94; p =.01) predicted improved outcomes. Both androgen deprivation and HER‐2‐directed therapies had clinical benefit beyond the first‐line metastatic setting, with partial response observed beyond second‐line use. Conclusion: Although prospective data are lacking, the use of adjuvant trastuzumab in high‐risk patients with SGC appears beneficial, particularly among patients with tumors exhibiting HER‐2/neu 3+ immunostaining. Implications for Practice: Results of this study showed an improved disease‐free and overall survival in patients treated with adjuvant trastuzumab for high‐risk salivary gland cancers with strong HER‐2/neu staining intensity. Following recurrence or metastatic spread, sequential HER‐2, and androgen‐directed therapies may benefit certain patients with salivary gland cancer. This article evaluates long‐term outcomes in patients with HER2‐positive salivary gland cancer (SGC) who received adjuvant HER2‐directed therapy and in patients with recurrent or metastatic non‐adenoid cystic carcinoma SGC treated with sequential androgen deprivation therapy and/or HER2‐directed therapies over time.
- Subjects
ADJUVANT treatment of cancer; CELL receptors; GENE expression; HEALTH status indicators; ONCOGENES; SALIVARY gland tumors; STAINS &; staining (Microscopy); SURVIVAL analysis (Biometry); TRASTUZUMAB; DISEASE relapse; TREATMENT effectiveness; DISEASE prevalence; ANDROGEN receptors; DESCRIPTIVE statistics; CHEMORADIOTHERAPY
- Publication
Oncologist, 2020, Vol 25, Issue 7, p598
- ISSN
1083-7159
- Publication type
Article
- DOI
10.1634/theoncologist.2019-0841