Case report

Cetuximab in the treatment of metastatic mucoepidermoid carcinoma of the salivary glands: A case report and review of literature

Salvatore Grisanti¹ , Vito Amoroso¹ , Michela Buglione² , Anna Rosati³ , Roberto Gatta² , Claudio Pizzocaro⁴ , Vittorio D Ferrari¹ and Giovanni Marini¹

¹  Department of Medical Oncology, Azienda Spedali Civili, Brescia, Italy

²  Department of Radiotherapy Oncology, University of Brescia, Brescia, Italy

³  Department of Neurology, University of Brescia, Brescia, Italy

⁴  Department of Nuclear Medicine, University of Brescia, Brescia, Italy

author email corresponding author email

Journal of Medical Case Reports 2008, 2:320doi:10.1186/1752-1947-2-320

Published:	30 September 2008

Abstract

Introduction

Patients with metastatic mucoepidermoid carcinoma of salivary glands have a poor outcome. The epidermal growth factor receptor protein is overexpressed in approximately 70% of mucoepidermoid carcinoma patients and may represent a therapeutic target. However, whether treatment with anti-epidermal growth factor receptor agents is effective is unclear and clinical trials are difficult due to the rarity of the disease. Here we assessed the activity of cetuximab in mucoepidermoid carcinoma on a molecular basis.

Case presentation

We present the case of a 40-year old Caucasian man with a mucoepidermoid carcinoma of the major salivary glands who developed distant bone and visceral metastases despite platinum-based chemotherapy. Epidermal growth factor receptor was overexpressed and fluorescence in situ hybridization analysis demonstrated a chromosome 7 polysomy. The patient was treated with the monoclonal antibody cetuximab in combination with cisplatin. After 11 doses of cetuximab, the patient developed brain metastases but evidence of response was documented at all extracranial metastatic sites.

Conclusion

This case report indicates that cetuximab can be active in mucoepidermoid carcinoma and may restore sensitivity to cisplatin in platinum-treated patients. Cetuximab does not cross the blood brain barrier and may select a metastatic clone to home the central nervous system while responding at other sites.