Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press111210.17650/2222-1468-2025-15-3-131-139CLINICAL CASEКЛИНИЧЕСКИЙ СЛУЧАЙEfficacy of trastuzumab in treatment of disseminated HER2-positive ductal adenocarcinoma of the submandibular gland (a case report)Эффективность применения трастузумаба в лечении диссеминированной HER2-положительной протоковой аденокарциномы подчелюстной слюнной железы (клинический случай)https://orcid.org/0000-0002-0918-3857MudunovA. M.МудуновА. М.
Russian Federation

111 1st Uspenskoe Shosse, Lapino, Moscow  Region 143081

Bld. 2, 8 Trubetskaya St., Moscow 119991

143081 Московская обл., д. Лапино, 1-е Успенское шоссе, 111

119991 Москва, ул. Трубецкая, 8, стр. 2

https://orcid.org/0000-0002-4496-6128GelfandI. M.ГельфандИ. М.
Russian Federation

Igor Mikhailovich Gelfand

28 Orekhovy Bul’var, Moscow 115682

Игорь Михайлович Гельфанд

115682 Москва, Ореховый бульвар, 28

igorgelf@yandex.ruhttps://orcid.org/0000-0002-8483-0081RyzhovaO. D.РыжоваО. Д.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0000-0003-4546-0011PakM. B.ПакМ. Б.
Russian Federation

66 Sevastopolsky Prospekt, 116152 Moscow

116152 Москва, Севастопольский пр-кт, 66

https://orcid.org/0009-0009-2014-1250TarakanovaA. S.ТаракановаА. С.
Russian Federation

Bld. 2, 8 Trubetskaya St., Moscow 119991

119991 Москва, ул. Трубецкая, 8, стр. 2

https://orcid.org/0009-0008-3522-3040TarakanovТаракановИ. О.
Russian Federation

Bld. 2, 8 Trubetskaya St., Moscow 119991

119991 Москва, ул. Трубецкая, 8, стр. 2

https://orcid.org/0009-0009-7914-5539MorozovaA. S.МорозоваА. С.
Russian Federation

Bld. 44, 2 Lobachevsogo St., Moscow119415

119415  Москва, ул. Лобачевского, 42, стр. 4

https://orcid.org/0000-0001-7690-731XChenH.ЧэньХ.
China

8 South Gongren Gymnasium Road, Chaoyang District, Beijing 100006

100006 Пекин, район Чаоян, South Gongren Gymnasium Road, 8

Clinical Hospital “Lapino” of the “Mother and Child” Group of companiesКлинический госпиталь «Лапино» группы компаний «Мать и дитя»Sechenov University, Ministry of Health of RussiaФГАОУ ВО Первый Московский государственный медицинский университет им. И. М. Сеченова Минздрава России (Сеченовский Университет)Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies, Federal Medical and Biological Agency of RussiaФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства России»N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр онкологии им. Н. Н. Блохина» Минздрава РоссииSpecialized Medical Center of the Bank of RussiaМногопрофильный медицинский центр Банка РоссииSechenov University, Ministry of Health of RussiaФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский Университет)Clinic “K+31”Клиника «К+31»Beijing Chao-Yang hospital, Capital Medical UniversityПекинская больница Чао-Ян, Столичный медицинский университет031120251531311390311202503112025Copyright ©; 2025, Mudunov A.M., Gelfand I.M., Ryzhova O.D., Pak M.B., Tarakanova A.S., Tarakanov ., Morozova A.S., Chen H.Copyright ©; 2025, Мудунов А.М., Гельфанд И.М., Рыжова О.Д., Пак М.Б., Тараканова А.С., Тараканов И.О., Морозова А.С., Чэнь Х.2025Mudunov A.M., Gelfand I.M., Ryzhova O.D., Pak M.B., Tarakanova A.S., Tarakanov ., Morozova A.S., Chen H.Мудунов А.М., Гельфанд И.М., Рыжова О.Д., Пак М.Б., Тараканова А.С., Тараканов И.О., Морозова А.С., Чэнь Х.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/1112

Ductal adenocarcinoma of the gland is a rare malignancy characterized by high rate of metastasis and poor survival. Immunohistochemical findings indicate that 40 % of patients demonstrate overexpression of the human epidermal growth factor receptor 2 (HER2) (2–3+). In patients with distant metastases, targeted anti-HER2 therapy is the only effective method.

This article describes our experience of successful targeted therapy in a patient with HER2-positive ductal adenocarcinoma of the submandibular gland.

Протоковая аденокарцинома слюнной железы является редкой злокачественной опухолью, характеризующeйся высокой частотой метастазирования и низкими показателями выживаемости. по данным иммуногистохимического исследования, у 40 % пациентов отмечается высокая экспрессия рецептора эпидермального фактора роста 2-го типа (HER2) (2–3+). при наличии отдаленных метастазов таргетная анти-HER2-терапия является единственным эффективным методом.

В статье представлен опыт успешного применения таргентной терапии при HER2-положительной потоковой аденокарциноме подчелюстной слюнной железы.

submandibular glandductal adenocarcinomaepidermal growth factor receptor type 2distant metastasestrastuzumabpaclitaxelподчелюстная слюнная железапротоковая аденокарциномарецептор эпидермального фактора роста 2-го типаотдаленные метастазытрастузумабпаклитаксел1. Jaehne M., Roeser K., Jaekel T. et al. Clinical and immunohistologic typing of salivary duct carcinoma: a report of 50 cases. Cancer 2005;103(12):2526–33. DOI: 10.1002/cncr.21116Jaehne M., Roeser K., Jaekel T. et al. Clinical and immunohistologic typing of salivary duct carcinoma: a report of 50 cases. Cancer 2005;103(12):2526–33. DOI: 10.1002/cncr.211162. Luukkaa H., Klemi P., Leivo I. et al. Salivary gland cancer in Finland 1991–96: an evaluation of 237 cases. Acta Otolaryngol 2005;125(2):207–14. DOI: 10.1080/00016480510003174Luukkaa H., Klemi P., Leivo I. et al. Salivary gland cancer in Finland 1991–96: an evaluation of 237 cases. Acta Otolaryngol 2005;125(2):207–14. DOI: 10.1080/000164805100031743. Barnes L., Rao U., Krause J. et al. Salivary duct carcinoma. Part I. A clinicopathologic evaluation and DNA image analysis of 13 cases with review of the literature. Oral Surg Oral Med Oral Pathol 1994;78(1):64–73. DOI: 10.1016/0030-4220(94)90119-8Barnes L., Rao U., Krause J. et al. Salivary duct carcinoma. Part I. A clinicopathologic evaluation and DNA image analysis of 13 cases with review of the literature. Oral Surg Oral Med Oral Pathol 1994;78(1):64–73. DOI: 10.1016/0030-4220(94)90119-84. Laurie S.A., Licitra L. Systemic therapy in the palliative management of advanced salivary gland cancers. J Clin Oncol 2006;24(17):2673–8. DOI: 10.1200/JCO.2005.05.3025Laurie S.A., Licitra L. Systemic therapy in the palliative management of advanced salivary gland cancers. J Clin Oncol 2006;24(17):2673–8. DOI: 10.1200/JCO.2005.05.30255. Seifert G., Brocheriou C., Cardesa A., Eveson J.W. WHO international histological classification of tumours. Tentative Histological Classification of Salivary Gland Tumours.Pathol Res Pract 1990;186(5):555–81. DOI: 10.1016/S0344-0338(11)80220-7Seifert G., Brocheriou C., Cardesa A., Eveson J.W. WHO international histological classification of tumours. Tentative Histological Classification of Salivary Gland Tumours.Pathol Res Pract 1990;186(5):555–81. DOI: 10.1016/S0344-0338(11)80220-76. Kleinsasser O., Klein H.J., Hubner G. Salivary duct carcinoma. A group of salivary gland tumors analogous to mammary duct carcinoma. Arch Klin Exp Ohren Nasen Kehlkopfheilkd 1968;192(1):100–5. (In German).Kleinsasser O., Klein H.J., Hubner G. Salivary duct carcinoma. A group of salivary gland tumors analogous to mammary duct carcinoma. Arch Klin Exp Ohren Nasen Kehlkopfheilkd 1968;192(1):100–5. (In German).7. Scholl S., Beuzeboc P., Pouillart P. Targeting HER2 in other tumor types. Ann Oncol 2001;12(Suppl 1):S81–7. DOI: 10.1093/annonc/12.suppl_1.s81Scholl S., Beuzeboc P., Pouillart P. Targeting HER2 in other tumor types. Ann Oncol 2001;12(Suppl 1):S81–7. DOI: 10.1093/annonc/12.suppl_1.s818. Williams M.D., Roberts D., Blumenschein G.R. et al. Differential expression of hormonal and growth factor receptors in salivary duct carcinomas: biologic significance and potential role in therapeutic stratification of patients. Am J Surg Pathol 2007;31(11):1645–52. DOI: 10.1097/PAS.0b013e3180caa099Williams M.D., Roberts D., Blumenschein G.R. et al. Differential expression of hormonal and growth factor receptors in salivary duct carcinomas: biologic significance and potential role in therapeutic stratification of patients. Am J Surg Pathol 2007;31(11):1645–52. DOI: 10.1097/PAS.0b013e3180caa0999. Otsuka K., Imanishi Y., Habu N. et al. Survival analysis and immunohistochemical study of HER-2 and AR (androgen receptor) expression in salivary duct carcinoma. Nihon Jibiinkoka Gakkai Kaiho 2013;116(9):1024–32. DOI: 10.3950/jibiinkoka.116.1024Otsuka K., Imanishi Y., Habu N. et al. Survival analysis and immunohistochemical study of HER-2 and AR (androgen receptor) expression in salivary duct carcinoma. Nihon Jibiinkoka Gakkai Kaiho 2013;116(9):1024–32. DOI: 10.3950/jibiinkoka.116.102410. Masubuchi T., Tada Y., Maruya S. et al. Clinicopathological significance of androgen receptor, HER2, Ki-67 and EGFR expressions in salivary duct carcinoma. Int J Clin Oncol 2015;20(1):35–44. DOI: 10.1007/s10147-014-0674-6Masubuchi T., Tada Y., Maruya S. et al. Clinicopathological significance of androgen receptor, HER2, Ki-67 and EGFR expressions in salivary duct carcinoma. Int J Clin Oncol 2015;20(1):35–44. DOI: 10.1007/s10147-014-0674-611. Skálová A., Stárek .I, Vanecek T. et al. Expression of HER2/neu gene and protein in salivary duct carcinomas of parotid gland as revealed by fluorescence in situ hybridization and immunohistochemistry. Histopathology 2003;42(4):348–56. DOI: 10.1046/j.1365-2559.2003.01600.xSkálová A., Stárek .I, Vanecek T. et al. Expression of HER2/neu gene and protein in salivary duct carcinomas of parotid gland as revealed by fluorescence in situ hybridization and immunohistochemistry. Histopathology 2003;42(4):348–56. DOI: 10.1046/j.1365-2559.2003.01600.x12. Marty M., Cognetti F., Maraninchi D. et al. Randomized phase II trial of the efficacy and safety of trastuzumab combined with docetaxel in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer administered as firstline treatment: the M77001 study group. J Clin Oncol 2005;23(19):4265–74. DOI: 10.1200/JCO.2005.04.173Marty M., Cognetti F., Maraninchi D. et al. Randomized phase II trial of the efficacy and safety of trastuzumab combined with docetaxel in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer administered as firstline treatment: the M77001 study group. J Clin Oncol 2005;23(19):4265–74. DOI: 10.1200/JCO.2005.04.17313. Nabili V., Tan J.W., Bhuta S. et al. Salivary duct carcinoma: a clinical and histologic review with implications for trastuzumab therapy. Head Neck 2007;29(10):907–12. DOI: 10.1002/hed.20614Nabili V., Tan J.W., Bhuta S. et al. Salivary duct carcinoma: a clinical and histologic review with implications for trastuzumab therapy. Head Neck 2007;29(10):907–12. DOI: 10.1002/hed.2061414. Limaye S.A., Posner M.R., Krane J.F. et al. Trastuzumab for the treatment of salivary duct carcinoma. Oncologist 2013;18(3):294–300. DOI: 10.1634/theoncologist.2012-0369Limaye S.A., Posner M.R., Krane J.F. et al. Trastuzumab for the treatment of salivary duct carcinoma. Oncologist 2013;18(3):294–300. DOI: 10.1634/theoncologist.2012-036915. Brandwein-Gensler M.S., Skalova A., Nagao T. Salivary duct carcinoma. In: World Health Organization classification of tumours: pathology and genetics of head and neck tumours. Ed. by L. Barnes, J.W. Eveson, P. Reichart, D. Sidranksky. Lyon: IARC Press, 2005. Pp. 236–237.Brandwein-Gensler M.S., Skalova A., Nagao T. Salivary duct carcinoma. In: World Health Organization classification of tumours: pathology and genetics of head and neck tumours. Ed. by L. Barnes, J.W. Eveson, P. Reichart, D. Sidranksky. Lyon: IARC Press, 2005. Pp. 236–237.16. Etges A., Pinto D.S., Kowalski L.P. et al. Salivary duct carcinoma: immunohistochemical profile of an aggressive salivary gland tumour. J Clin Pathol 2003;56(12):914–8. DOI: 10.1136/jcp.56.12.914Etges A., Pinto D.S., Kowalski L.P. et al. Salivary duct carcinoma: immunohistochemical profile of an aggressive salivary gland tumour. J Clin Pathol 2003;56(12):914–8. DOI: 10.1136/jcp.56.12.91417. Haddad R., Colevas A.D., Krane J.F. et al. Herceptin in patients with advanced or metastatic salivary gland carcinomas. A phase II study. Oral Oncol 2003;39(7):724–7. DOI: 10.1016/s1368-8375(03)00097-6Haddad R., Colevas A.D., Krane J.F. et al. Herceptin in patients with advanced or metastatic salivary gland carcinomas. A phase II study. Oral Oncol 2003;39(7):724–7. DOI: 10.1016/s1368-8375(03)00097-618. Press M.F., Pike M.C., Hung G. et al. Amplification and overexpression of HER-2/neu in carcinomas of the salivary gland: correlation with poor prognosis. Cancer Res 1994;54(21):5675–82.Press M.F., Pike M.C., Hung G. et al. Amplification and overexpression of HER-2/neu in carcinomas of the salivary gland: correlation with poor prognosis. Cancer Res 1994;54(21):5675–82.19. Glisson B., Colevas A.D., Haddad R. et al. HER2 expression in salivary gland carcinomas: dependence on histological subtype. Clin Cancer Res 2004;10(3):944–6. DOI: 10.1158/1078-0432.ccr-03-025Glisson B., Colevas A.D., Haddad R. et al. HER2 expression in salivary gland carcinomas: dependence on histological subtype. Clin Cancer Res 2004;10(3):944–6. DOI: 10.1158/1078-0432.ccr-03-02520. McKeage K., Perry C.M. Trastuzumab: a review of its usein the treatment of metastatic breast cancer overexpressing HER-2. Drugs 2002;62(1):209–43. DOI: 10.2165/00003495-200262010-00008McKeage K., Perry C.M. Trastuzumab: a review of its usein the treatment of metastatic breast cancer overexpressing HER-2. Drugs 2002;62(1):209–43. DOI: 10.2165/00003495-200262010-0000821. Bell R. Ongoing trials with trastuzumab in metastaticbreast cancer. Ann Oncol 2001;12(Suppl 1):S69–73. DOI: 10.1093/annonc/12.suppl_1.s69Bell R. Ongoing trials with trastuzumab in metastaticbreast cancer. Ann Oncol 2001;12(Suppl 1):S69–73. DOI: 10.1093/annonc/12.suppl_1.s6922. Treish I., Schwartz R., Lindley C. Pharmacology and therapeutic use of trastuzumab in breast cancer. Am J Health Syst Pharm 2000;57(22):2063–79.Treish I., Schwartz R., Lindley C. Pharmacology and therapeutic use of trastuzumab in breast cancer. Am J Health Syst Pharm 2000;57(22):2063–79.23. Baselga J. Clinical trials of Herceptin (trastuzumab). Eur J Cancer 2001;37(Suppl 1):S18–24.Baselga J. Clinical trials of Herceptin (trastuzumab). Eur J Cancer 2001;37(Suppl 1):S18–24.24. Baselga J. Clinical trials of single-agent trastuzumab (Herceptin). Semin Oncol 2000;27(5, Suppl 9):20–6.Baselga J. Clinical trials of single-agent trastuzumab (Herceptin). Semin Oncol 2000;27(5, Suppl 9):20–6.25. Vogel C., Cobleigh M., Tripathy et al. Efficacy andsafety of trastuzumab as a single agent in first-linetreatment of HER-2overexpressing metastatic breastcancer. J Clin Oncol 2002;20(3):719–26. DOI: 10.1200/JCO.2002.20.3.719Vogel C., Cobleigh M., Tripathy et al. Efficacy andsafety of trastuzumab as a single agent in first-linetreatment of HER-2overexpressing metastatic breastcancer. J Clin Oncol 2002;20(3):719–26. DOI: 10.1200/JCO.2002.20.3.71926. Cortazar P., Zhang L., Untch M. et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet 2014;384(9938):164–72. DOI: 10.1016/S0140-6736(13)62422-8Cortazar P., Zhang L., Untch M. et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet 2014;384(9938):164–72. DOI: 10.1016/S0140-6736(13)62422-827. Peddi P.F., Hurvitz S.A. Trastuzumab emtansine: the first targeted chemotherapy for treatment of breast cancer. Future Oncol 2013;9(3):319–26. DOI: 10.2217/fon.13.7Peddi P.F., Hurvitz S.A. Trastuzumab emtansine: the first targeted chemotherapy for treatment of breast cancer. Future Oncol 2013;9(3):319–26. DOI: 10.2217/fon.13.728. Lambert J.M., Chari R.J. Ado-trastuzumab emtansine (T-DM1): an antibody-drug conjugate (ADC) for HER2-positive breast cancer. J Med Chem 2014;57(16):6949–64. DOI: 10.1021/jm500766wLambert J.M., Chari R.J. Ado-trastuzumab emtansine (T-DM1): an antibody-drug conjugate (ADC) for HER2-positive breast cancer. J Med Chem 2014;57(16):6949–64. DOI: 10.1021/jm500766w29. Welslau M., Diéras V., Sohn J.H. et al. Patient-reported outcomes from EMILIA, a randomized phase 3 study of trastuzumab emtansine (T-DM1) versus capecitabine and lapatinib in human epidermal growth factor receptor 2-positive locally advanced or metastatic breast cancer. Cancer 2014;120(5):642–51. DOI: 10.1002/cncr.28465Welslau M., Diéras V., Sohn J.H. et al. Patient-reported outcomes from EMILIA, a randomized phase 3 study of trastuzumab emtansine (T-DM1) versus capecitabine and lapatinib in human epidermal growth factor receptor 2-positive locally advanced or metastatic breast cancer. Cancer 2014;120(5):642–51. DOI: 10.1002/cncr.2846530. Meric-Bernstam F., Makker V., Oaknin A. et al. Efficacy and safety of trastuzumab deruxtecan in patients with her2-expressing solid tumors: primary results from the DESTINY-PanTumor02 phase II trial. J Clin Oncol 2024;42(1):47–58. DOI: 10.1200/JCO.23.02005Meric-Bernstam F., Makker V., Oaknin A. et al. Efficacy and safety of trastuzumab deruxtecan in patients with her2-expressing solid tumors: primary results from the DESTINY-PanTumor02 phase II trial. J Clin Oncol 2024;42(1):47–58. DOI: 10.1200/JCO.23.0200531. Takahashi S., Bando H., Kinoshita I. et al. Trastuzumab deruxtecan in patients with human epidermal growth factor receptor 2-expressing salivary gland carcinoma: a pooled analysis of two phase I studies. Jpn J Clin Oncol 2024;54(4):434–43. DOI: 10.1093/jjco/hyad181Takahashi S., Bando H., Kinoshita I. et al. Trastuzumab deruxtecan in patients with human epidermal growth factor receptor 2-expressing salivary gland carcinoma: a pooled analysis of two phase I studies. Jpn J Clin Oncol 2024;54(4):434–43. DOI: 10.1093/jjco/hyad181