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Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Role of ado-trastuzumab emtansine (T-DM1) in HER2 positive salivary gland tumour with brain metastasis
  1. Nilesh Dhamne1,
  2. Venkata Pradeep Babu Koyyala2,
  3. Snehal Chougule3 and
  4. Suraj Pawar4
  1. 1Medical Oncology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
  2. 2Medical Oncology, Tezpur Cancer Centre, Assam Cancer Care Foundation, Tezpur, Assam, India
  3. 3Neurology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
  4. 4Surgical Oncology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
  1. Correspondence to Dr Venkata Pradeep Babu Koyyala; venkata.pradeep{at}accf.in

Abstract

Malignant neoplasms of salivary gland neoplasms are rare and often involve the parotid gland. The primary treatment of these malignancies is surgery with or without adjuvant therapy. Chemotherapy or systemic therapy is indicated in recurrent or metastatic disease where surgery or radiotherapy is not possible. Salivary gland carcinomas, which are human epidermal growth factor receptor 2 (HER2) positive, show an aggressive behaviour with a poor prognosis. Targeting the HER2 pathway with drugs designed to block this pathway is an interesting novel therapy to treat salivary gland carcinomas. We report a case of a patient with HER 2-overexpressing parotid gland adenocarcinoma with brain metastasis, who was managed with ado-trastuzumab emtansine (T-DM1): a monoclonal antibody-cytotoxic drug conjugate that combines trastuzumab with the microtubule inhibitor, emtansine. The patient showed excellent response to the therapy. This case highlights the role of systemic chemotherapy with T-DM1 in HER2 positive salivary gland tumours that could be considered a part of the treatment regimen.

  • Head and neck cancer
  • Pharmacology and therapeutics
  • Therapeutic indications

https://doi.org/10.1136/bcr-2021-248576

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    Footnotes

    • Twitter @pradeepbab

    • Contributors ND has identified this case as reportable, took patient consent for the same. VPB has taken detailed history, collected reports, wrote the outline of the case report. SC has edited and wrote the part concerned with brain metastasis, labelled the scans as needed. SP edited the entire manuscript as per BMJ requirements, counselled the patient and their family.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.