Diagnostic challenges and successful organ-preserving therapy in a case of secretory carcinoma of minor salivary glands.
NTRK fusion
head and neck cancer
larotrectinib
minor salivary glands
secretory carcinoma
Journal
Cancer reports (Hoboken, N.J.)
ISSN: 2573-8348
Titre abrégé: Cancer Rep (Hoboken)
Pays: United States
ID NLM: 101747728
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
revised:
14
06
2021
received:
04
05
2021
accepted:
22
06
2021
pubmed:
8
7
2021
medline:
26
4
2022
entrez:
7
7
2021
Statut:
ppublish
Résumé
Secretory carcinoma is a more recently described subtype of salivary gland carcinoma that may pose diagnostic challenges and frequently harbors NTRK fusions that may successfully be targeted by TRK inhibitors in advanced disease. We present the case of a female patient with secretory carcinoma arising in the base of tongue with persistent disease after debulking surgery and definitive chemoradiation. As an alternative to salvage surgery, which would have resulted in significant impairment of swallowing and speech function, a targeted therapy with the TRK-inhibitor larotrectinib against an identified ETV6-NTRK3 fusion product was initiated. Larotrectinib treatment has been well tolerated, resulted in durable complete response and the patient maintains good swallowing and speech function. The presented case underscores the importance of the accurate diagnosis of secretory carcinoma. It further highlights the impact of molecular testing as targeted therapies may play an important role in the management of advanced salivary gland cancers.
Sections du résumé
BACKGROUND
Secretory carcinoma is a more recently described subtype of salivary gland carcinoma that may pose diagnostic challenges and frequently harbors NTRK fusions that may successfully be targeted by TRK inhibitors in advanced disease.
CASE
We present the case of a female patient with secretory carcinoma arising in the base of tongue with persistent disease after debulking surgery and definitive chemoradiation. As an alternative to salvage surgery, which would have resulted in significant impairment of swallowing and speech function, a targeted therapy with the TRK-inhibitor larotrectinib against an identified ETV6-NTRK3 fusion product was initiated. Larotrectinib treatment has been well tolerated, resulted in durable complete response and the patient maintains good swallowing and speech function.
CONCLUSION
The presented case underscores the importance of the accurate diagnosis of secretory carcinoma. It further highlights the impact of molecular testing as targeted therapies may play an important role in the management of advanced salivary gland cancers.
Identifiants
pubmed: 34231337
doi: 10.1002/cnr2.1491
pmc: PMC8955062
doi:
Substances chimiques
Oncogene Proteins, Fusion
0
Types de publication
Case Reports
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1491Subventions
Organisme : NCI NIH HHS
ID : P01 CA240239
Pays : United States
Organisme : postdoc.mobility fellowship of the Swiss National Science Foundation
ID : P400PM_183852
Informations de copyright
© 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC.
Références
Mod Pathol. 2017 Jan;30(s1):S27-S43
pubmed: 28060365
Nat Med. 2019 Sep;25(9):1422-1427
pubmed: 31406350
Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Oct;132(4):e143-e152
pubmed: 32493686
N Engl J Med. 2018 Feb 22;378(8):731-739
pubmed: 29466156
Am J Surg Pathol. 2010 May;34(5):599-608
pubmed: 20410810
Nat Med. 2014 Dec;20(12):1479-84
pubmed: 25384085
Hum Pathol. 2019 Jan;83:50-58
pubmed: 30130630
Head Neck Pathol. 2013 Mar;7(1):35-9
pubmed: 23459839
Am J Surg Pathol. 2020 Oct;44(10):1295-1307
pubmed: 32675658
Mod Pathol. 2020 Apr;33(4):541-550
pubmed: 31822803
Cancer Rep (Hoboken). 2022 Mar;5(3):e1491
pubmed: 34231337
Appl Immunohistochem Mol Morphol. 2020 Jul;28(6):e53
pubmed: 31517643
Adv Anat Pathol. 2021 May 1;28(3):107-118
pubmed: 33825717
Lancet Oncol. 2020 Feb;21(2):271-282
pubmed: 31838007
Case Rep Pathol. 2019 Mar 27;2019:2074504
pubmed: 31032132
Cancer Discov. 2017 Sep;7(9):963-972
pubmed: 28578312
Histopathology. 2019 Jul;75(1):54-62
pubmed: 30801752
Lancet Oncol. 2020 Apr;21(4):531-540
pubmed: 32105622