Neoadjuvant treatment with trastuzumab and folfox induces a complete pathologic response in a metastatic ERBB2 (HER2)-Amplified Duodenal Cancer

Ahmad Hamad, Aatur D. Singhi, Nathan Bahary, Kevin McGrath, Rula Amarin, Herbert J. Zeh, Amer H. Zureikat

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Overexpression of HER2 protein and amplification of the ERBB2 gene has been observed in various adenocarcinomas, providing a therapeutic target that can be used to extend the survival of a select cohort of patients. Anti-HER2 therapy has been successfully applied to gastric and colorectal cancers, but its use and potential benefit in small intestinal carcinomas is not well characterized. We applied anti-HER2 therapy to an ERBB2-amplified advanced duodenal adenocarcinoma, adding trastuzumab to FOLFOX in the neoadjuvant setting. A 61-year-old woman with an advanced duodenal cancer harboring an ERBB2 amplification received preoperative trastuzumab and FOLFOX. Restaging revealed significant tumor downstaging with no metastasis. After multidisciplinary assessment, she underwent pancreaticoduo-denectomy. Final pathologic analysis revealed no residual invasive adenocarcinoma, consistent with a complete neoadjuvant treatment response. This case report emphasizes the need for further molecular characterization of small bowel cancers; genetic alterations may provide therapeutic targets to improve the prognosis of these rare and aggressive malignancies.

Original languageEnglish (US)
Pages (from-to)983-988
Number of pages6
JournalJNCCN Journal of the National Comprehensive Cancer Network
Volume15
Issue number8
DOIs
StatePublished - Aug 2017
Externally publishedYes

ASJC Scopus subject areas

  • Oncology

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