Introduction Salivary duct carcinoma (SDC) is an aggressive and rare subtype of salivary gland carcinoma. Surgical excision and radiotherapy are standard of care for early cancer. Chemotherapies with taxanes and platinum show overall response rates between 39% and 50%. SDCs are often associated with an overexpression of the androgen receptor (AR) and HER2/neu which have recently become druggable targets. Case Presentation Here, we report on an 84-year-old male patient with metastatic SDC of the right parotid gland. In 2017, he underwent a right total parotidectomy, a right neck dissection, and an infratemporal fossa clearance followed by 6 weeks of radiotherapy. In 2018, due to metastatic spread in the lungs, bones, and pararenal gland, a pathological workup of the tumor tissue was performed and revealed both AR and HER2 overexpression, respectively. Consequently, he underwent androgen deprivation therapy and, due to asymptomatic progression, sequentially human epidermal growth factor receptor 2 (HER-2)-targeted therapy with ado-trastuzumab emtansine and neratinib, which led to stable disease during the course of about 18 months. The electronically captured patient-reported outcome had demonstrated a good tolerance of all three therapeutic lines. Conclusion In conclusion, since effective standard therapeutic treatment options for SDC may often not be tolerable in older patients, the implementation of personalized and adaptive treatments, especially in patients with rare tumor types, might offer valuable treatment options.

中文翻译：

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具有 ERBB2 扩增和对 Ado-Trastuzumab Emtansine 和 Neratinib 的序贯反应的转移性唾液管癌：病例报告。

引言 唾液管癌（SDC）是唾液腺癌的一种侵袭性且罕见的亚型。手术切除和放射治疗是早期癌症的标准治疗方法。紫杉烷类药物和铂类化疗的总体缓解率在 39% 至 50% 之间。SDC 通常与雄激素受体 (AR) 和 HER2/neu 的过度表达有关，这些受体最近已成为药物靶点。病例介绍 在此，我们报告一名 84 岁男性患者，患有右腮腺转移性 SDC。2017 年，他接受了右侧腮腺全切除术、右侧颈清扫术和颞下窝清理术，随后进行了 6 周的放射治疗。2018年，由于肺部、骨骼和肾旁腺的转移扩散，对肿瘤组织进行了病理检查，结果分别显示 AR 和 HER2 过度表达。因此，他接受了雄激素剥夺治疗，并且由于无症状进展，相继接受了 ado-trastuzumab emtansine 和 neratinib 的人表皮生长因子受体 2 (HER-2) 靶向治疗，在大约 18 个月的过程中病情稳定。电子捕获的患者报告结果表明，所有三种治疗线均具有良好的耐受性。结论 总之，由于老年患者对 SDC 的有效标准治疗方案可能往往无法耐受，因此实施个性化和适应性治疗，尤其是罕见肿瘤类型的患者，可能会提供有价值的治疗方案。