Neratinib and the Role of Anti-HER2 Therapy in Salivary Duct Carcinoma.

BACKGROUD: Salivary duct carcinoma (SDC) is a rare and aggressive malignancy with a generally dismal prognosis and no standard of care established, despite a known association with epidermal growth factor receptor 2 (HER2) and androgen receptor (AR) over-expression. CASE: We report the case of a 64-year-old female with extra- and intracranial metastases of SDC with evidence of AR and HER2 overexpression. After progression on first line chemotherapy, was administered neratinib, a pan-Erb2 receptor tyrosine kinase inhibitor. Even with central nervous system involvement at diagnosis, a durable clinical response was obtained with a PFS of 11 months and no significant toxicities to manage. Best response observed during tratment was partial response. CONCLUSIONS: This case confirms the potential efficacy of neratinib in HER2-positive SDC and underlines the need to define the best therapeutic sequence and potential biomarkers for these rare patients.