Eline Boon

Androgen deprivation therapy for androgen receptor-positive advanced salivary duct carcinoma: A nationwide case series of 35 patients in The Netherlands

Salivary duct carcinoma, an aggressive subtype of salivary gland cancer, is mostly androgen receptor‐positive. Only limited data are available on androgen deprivation therapy (ADT).

Impact of chemotherapy on the outcome of osteosarcoma of the head and neck in adults

There is an ongoing debate about the value of (neo‐)adjuvant chemotherapy in high‐ and intermediate‐grade osteosarcoma of the head and neck.

Combination of docetaxel, trastuzumab and pertuzumab or treatment with trastuzumab-emtansine for metastatic salivary duct carcinoma

2017 The Authors. Published by Elsevier Ltd. This is anopenaccess article under the CCBY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Dear editor, With great interest we read the review of Alfieri et al. [1] concerning systemic therapies in metastatic salivary gland carcinomas. In addition to this, we hereby present our experience with novel HER2-targeted therapies in metastatic salivary duct carcinoma (SDC) patients. SDC is a rare and aggressive subtype of salivary gland cancer, with a median overall survival (OS) of 3–4 years after primary diagnosis [2–4]. As stated in the above mentioned review, responses to chemotherapy are poor and knowledge about new drugs is based on small studies. Next to this, many studies ‘‘lumped” patients with a spectrum of salivary gland cancers, failing to fully appreciate the impact of the heterogeneity in salivary gland cancer [5]. In SDC, HER2 is overexpressed in 21–44% [4,6,7] of the cases, and could serve as a therapeutical target [8]. In Table 1 we show the available evidence on HER2-targeted therapies for metastatic SDC. The most important study is a phase II clinical trial in 45 patients treated with docetaxel and trastuzumab for advanced HER2-positive SDC, in which preliminary results show an overall response rate of 69% and a median progression free survival (PFS) of 11.3 months [9]. In breast cancer, patients receiving docetaxel and trastuzumab for HER2-positive metastatic breast cancer have a median PFS of 12.4 months and median OS of 40.8 months. Adding pertuzumab to this regimen extents the median PFS and OS to 18.7 and 56.5 months, respectively [10]. Because of similarities in histology and HER2 status, we hypothesized that adding pertuzumab may also increase PFS in SDC. In this letter to the editor we describe two patients treated with the combination of docetaxel, trastuzumab and pertuzumab in our clinic. Additionally, we demonstrate in one patient that after disease progression another line of HER2-targeted therapy with trastuzumab-emtansine can be beneficial. http://dx.doi.org/10.1016/j.oraloncology.2017.06.023 1368-8375/ 2017 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). ⇑ Corresponding author at: Geert Grooteplein Zuid 8, P.O. Box 9101, 6525 GA Nijmegen, The Netherlands. E-mail addresses: wim.vanboxtel@radboudumc.nl (W. van Boxtel), eline.boon@radboudumc.nl (E. Boon), willem.weijs@radboudumc.nl (W.L.J. Weijs), frank-KNO. vandenhoogen@radboudumc.nl (F.J.A. van den Hoogen), Uta.flucke@radboudumc.nl (U.E. Flucke), Carla.vanHerpen@radboudumc.nl (C.M.L. van Herpen). Oral Oncology 72 (2017) 198–200

Clinicopathological characteristics and outcome of 31 patients with ETV6-NTRK3 fusion gene confirmed (mammary analogue) secretory carcinoma of salivary glands

OBJECTIVES In 2010, a new subtype of salivary gland cancer (SGC), (mammary analogue) secretory carcinoma (SC), was defined, characterized by the ETV6-NTRK3 fusion gene. As clinical behavior and outcome data of this histological subtype tumor are still sparse, we aimed to describe the clinicopathological course and outcome of a series of translocation positive SC patients. PATIENT AND METHODS We re-evaluated the pathological diagnosis of a subset of SGCs, diagnosed in 4 of 8 Dutch head and neck centers. Subsequently, tumors with a morphological resemblance to SC were tested for the ETV6-NTRK3 fusion gene using RT-PCR. Furthermore, patients prospectively diagnosed with SC were included. The clinical characteristics and outcomes were retrieved from the patient files. RESULTS Thirty-one patients with ETV6-NTRK3 fusion gene positive SC were included. The median age was 49 years, 17 patients (55%) were male. Eighteen tumors (58%) arose in the parotid gland. One patient presented with lymph node metastasis. All patients underwent tumor resection and 4 patients had a neck dissection. Four patients had re-resection and 15 patients (48%) received postoperative radiotherapy. One patient developed a local recurrence, no regional recurrences or distant metastases were observed. After a median follow-up of 49 months the 5- and 10-year overall survival were 95%, the 5- and 10-year disease free survival were 89%. CONCLUSION The clinical course of SC is favorable with a low rate of locoregional recurrence and excellent survival. Given the low incidence of nodal metastases, elective neck treatment, i.e. surgery and/or radiotherapy, does not seem to be indicated.

A clinicopathological study and prognostic factor analysis of 177 salivary duct carcinoma patients from The Netherlands

Salivary duct carcinoma (SDC) is a subtype of salivary gland cancer with a dismal prognosis and a need for better prognostication and novel treatments. The aim of this national cohort study was to investigate clinical outcome, prognostic factors, androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2) expression. SDC patients diagnosed between 1990 and 2014 were identified by the Nationwide Network and Registry of Histo‐ and Cytopathology in the Netherlands (PALGA). Subsequently, medical records were evaluated and pathological diagnoses reviewed. Data were analyzed for overall survival (OS), disease‐free survival (DFS), distant metastasis‐free survival (DMFS) and prognostic factors. AR was evaluated by immunohistochemistry (IHC), HER2 by IHC and fluorescent in‐situ hybridization. A total of 177 patients were included. The median age was 65 years, 75% were male. At diagnosis, 68% presented with lymph node metastases and 6% with distant metastases. Median OS, DFS and DMFS were 51, 23 and 26 months, respectively. In patients presenting without distant metastases, the absolute number of positive lymph nodes was associated with poor OS and DMFS in a multivariable analysis. AR and HER2 were positive in 161/168 (96%) and 44/153 (29%) tumors, respectively, and were not prognostic factors. SDC has a dismal prognosis with primary lymph node involvement in the majority of patients. The absolute number of lymph node metastases was found to be the only prognostic factor for DMFS and OS. AR expression and—to a lesser extent—HER2 expression hold promise for systemic treatment in the metastatic and eventually adjuvant setting.Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible.