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Case Reports
. 2021 May 3:5:PO.20.00436.
doi: 10.1200/PO.20.00436. eCollection 2021.

Excellent Response With Alpelisib and Bicalutamide for Advanced Salivary Duct Carcinoma With PIK3CA Mutation and High Androgen Receptor Expression-A Case Report

Hardik Sheth  1 , Prashant Kumar  2   3   4 , Aditya Shreenivas  5 , Janani Sambath  2   3 , Ramya Pragya  1 , Chetan Madre  1 , Nevitha Athikari  1 , Hemant Khandare  1 , Vishal Peshattiwar  1 , Rajan Datar  4 , Sewanti Limaye  1
Affiliations
Case Reports

Excellent Response With Alpelisib and Bicalutamide for Advanced Salivary Duct Carcinoma With PIK3CA Mutation and High Androgen Receptor Expression-A Case Report

Hardik Sheth et al. JCO Precis Oncol. .
No abstract available

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Conflict of interest statement

The following represents disclosure information provided by the authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/po/author-center. Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments). Prashant Kumar Employment: Datar Cancer Genetics Research Funding: Datar Cancer Genetics Patents, Royalties, Other Intellectual Property: Patent from Singapore for discovery of bladder cancer biomarkerRajan Datar Stock and Other Ownership Interests: Datar Cancer Genetics Patents, Royalties, Other Intellectual Property: Multiple patents related to various technologies developed at Datar Cancer Genetics No other potential conflicts of interest were reported.Prashant Kumar Employment: Datar Cancer Genetics Research Funding: Datar Cancer Genetics Patents, Royalties, Other Intellectual Property: Patent from Singapore for discovery of bladder cancer biomarker Rajan Datar Stock and Other Ownership Interests: Datar Cancer Genetics Patents, Royalties, Other Intellectual Property: Multiple patents related to various technologies developed at Datar Cancer Genetics No other potential conflicts of interest were reported.Prashant Kumar Employment: Datar Cancer Genetics Research Funding: Datar Cancer Genetics Patents, Royalties, Other Intellectual Property: Patent from Singapore for discovery of bladder cancer biomarker Rajan Datar Stock and Other Ownership Interests: Datar Cancer Genetics Patents, Royalties, Other Intellectual Property: Multiple patents related to various technologies developed at Datar Cancer Genetics No other potential conflicts of interest were reported.

Figures

FIG 1.
FIG 1.
(A) Histopathologic findings on hematoxylin and eosin (H&E) staining of the salivary ductal carcinoma case at diagnosis (5×). (B) H&E staining of the salivary ductal carcinoma case at diagnosis (20×). (C) Immunohistochemistry (IHC) analysis for human epidermal growth factor receptor 2 (HER2)-overexpression showing HER2-positive score 3+ complete membranous in more than 10% tumor at diagnosis (5×). (D) IHC analysis for HER2-overexpression showing HER2-positive tumor cells (20×). (E) Nuclear staining of androgen receptor (AR) showing strong positive AR expression in all tumor cells at diagnosis (5×). (F) Nuclear staining of AR showing strong positive AR expression in all tumor cells at diagnosis (20×).
FIG 2.
FIG 2.
Current and previous positron emission tomography-computed tomography scans demonstrating response to treatment from PIK3CA and androgen receptor inhibitors. (A) Arrows show near-complete metabolic resolution of the primary lesion when compared with prior scans. (B) Arrows show complete metabolic resolution of the vertebral metastasis when compared with prior scans. (C) Arrows show complete metabolic resolution of the lung and vertebral metastasis when compared with prior scans. (D) Arrows show near-complete metabolic resolution of the primary lesion when compared with prior scans.
FIG 3.
FIG 3.
Depiction of treatment regimen and timeline of the patient with salivary duct carcinoma. AR, androgen receptor; HER2, human epidermal growth factor receptor 2; IHC, immunohistochemistry; PET-CT, positron emission tomography-computed tomography.
FIG 4.
FIG 4.
(A) Overview of PIK3CA gene with p.E545K domain-specific mutation. (B) A model of PI3K/mTOR pathway inhibition and AR deregulation in HER2-positive salivary duct carcinoma. AKT, XXX; AR, androgen receptor; ARE, androgen receptor element; CT, computed tomography; HER2, human epidermal growth factor receptor 2; mTOR, mammalian target of rapamycin; PDK1, 3 phosphoinositidine-dependent kinase 1; PET, positron emission tomography.
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