{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:27:46Z","timestamp":1787570866537,"version":"build-2736575974"},"reference-count":21,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,4]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Salivary duct carcinoma (SDC) of the parotid gland is a rare and aggressive malignancy. Conventional treatment for recurrent or metastatic disease commonly involves platinum-based chemotherapy and taxane-based regimens although treatment is increasingly informed by molecular profiling. A subset of these tumours are human epidermal growth factor receptor 2 (HER2) positive and are associated with more aggressive metastatic behaviour. Novel treatment approaches, particularly dual HER2-targeted therapies commonly used in breast cancer, are now being explored for clinical utility in this group.<\/jats:p>\n                  <jats:p>This case report describes a patient with recurrent metastatic SDC arising from a carcinoma ex-pleomorphic adenoma, with strong HER2 positivity. The patient was treated with a combination of monoclonal antibodies (trastuzumab and pertuzumab) and chemotherapy agents (carboplatin and paclitaxel). The patient demonstrated an excellent and sustained clinical response. This case supports the potential benefit of targeted anti-HER2 therapy in HER2-positive salivary gland tumours and suggests this strategy may be considered in future treatment protocols.<\/jats:p>","DOI":"10.1136\/bcr-2025-269218","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:15:16Z","timestamp":1787570116000},"page":"e269218","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["HER2-positive salivary duct carcinoma: durable response to targeted therapy and chemotherapy"],"prefix":"10.1136","volume":"19","author":[{"given":"Gavin","family":"Keogh","sequence":"first","affiliation":[{"name":"Oncology, St James\u2019s Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cliona","family":"Grant","sequence":"additional","affiliation":[{"name":"Oncology, St James\u2019s Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijal","family":"Shah","sequence":"additional","affiliation":[{"name":"Histopathology, St James\u2019s Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colm","family":"Mac Eochagain","sequence":"additional","affiliation":[{"name":"Oncology, St James\u2019s Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"2026082404150536000_19.8.e269218.1","doi-asserted-by":"publisher","DOI":"10.1200\/PO.17.00135"},{"key":"2026082404150536000_19.8.e269218.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2017.01.004"},{"key":"2026082404150536000_19.8.e269218.3","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-011-0281-z"},{"key":"2026082404150536000_19.8.e269218.4","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1001\/jamaoto.2020.2944","article-title":"Comparison of parotidectomy with observation for treatment of pleomorphic adenoma in adults","volume":"146","author":"Kligerman","year":"2020","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"2026082404150536000_19.8.e269218.5","doi-asserted-by":"crossref","DOI":"10.1259\/dmfr.20200485","article-title":"Carcinoma ex pleomorphic adenoma of major salivary glands: CT and MR imaging findings","volume":"50","author":"Wang","year":"2021","journal-title":"Dentomaxillofac Radiol"},{"key":"2026082404150536000_19.8.e269218.6","first-page":"1524","article-title":"HER2 expression in salivary duct carcinoma: a clinicopathologic study of 40 cases","volume":"39","author":"Nagao","year":"2015","journal-title":"Am J Surg Pathol"},{"key":"2026082404150536000_19.8.e269218.7","unstructured":"National Comprehensive Cancer Network . NCCN clinical practice guidelines in oncology (NCCN Guidelines\u00ae): Head and neck cancers. 2025. Available: https:\/\/www.nccn.org\/guidelines\/guidelines-detail?category=1&id=1438 [Accessed 2 Jul 2025]."},{"key":"2026082404150536000_19.8.e269218.8","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30863-0"},{"key":"2026082404150536000_19.8.e269218.9","doi-asserted-by":"crossref","first-page":"106612","DOI":"10.1016\/j.oraloncology.2023.106612","article-title":"HER2-targeted therapies for salivary gland cancers","volume":"148","author":"Filippini","year":"2024","journal-title":"Oral Oncol"},{"key":"2026082404150536000_19.8.e269218.10","doi-asserted-by":"crossref","first-page":"E100","DOI":"10.1002\/hed.25392","article-title":"Exceptional responses to pertuzumab, trastuzumab, and docetaxel in human epidermal growth factor receptor-2 high expressing salivary duct carcinomas","volume":"40","author":"Park","year":"2018","journal-title":"Head Neck"},{"key":"2026082404150536000_19.8.e269218.11","doi-asserted-by":"crossref","first-page":"2878","DOI":"10.1002\/ccr3.3209","article-title":"HER2-positive metastatic, parotid salivary duct carcinoma treated with a trastuzumab\/pertuzumab-based chemotherapy: a case report","volume":"8","author":"Longo","year":"2020","journal-title":"Clin Case Rep"},{"key":"2026082404150536000_19.8.e269218.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2019.11.018"},{"key":"2026082404150536000_19.8.e269218.13","doi-asserted-by":"crossref","first-page":"105703","DOI":"10.1016\/j.oraloncology.2021.105703","article-title":"Case series of docetaxel, trastuzumab, and pertuzumab (DTP) as first-line anti-HER2 therapy and ado-trastuzumab emtansine (T-DM1) as second-line therapy for recurrent or metastatic HER2-positive salivary duct carcinoma","volume":"125","author":"Uijen","year":"2022","journal-title":"Oral Oncol"},{"key":"2026082404150536000_19.8.e269218.14","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1158\/1535-7163.TARG-21-P154","article-title":"Abstract P154: Genomic profiling and matched therapy for recurrent or metastatic salivary gland neoplasms. Results from the matched cohort of the GEMS-001 clinical trial","volume":"20","author":"Hernando-Calvo","year":"2021","journal-title":"Mol Cancer Ther"},{"key":"2026082404150536000_19.8.e269218.15","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.00545"},{"key":"2026082404150536000_19.8.e269218.16","doi-asserted-by":"crossref","first-page":"2966","DOI":"10.1002\/cncr.34892","article-title":"A phase 2 multicenter study of docetaxel-PM and trastuzumab-pkrb combination therapy in recurrent or metastatic salivary gland carcinomas","volume":"129","author":"Lee","year":"2023","journal-title":"Cancer"},{"key":"2026082404150536000_19.8.e269218.17","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1093\/jjco\/hyaf106","article-title":"Multicenter phase II trial of trastuzumab and docetaxel for HER2-positive salivary gland cancer","volume":"55","author":"Kano","year":"2025","journal-title":"Jpn J Clin Oncol"},{"key":"2026082404150536000_19.8.e269218.18","doi-asserted-by":"crossref","first-page":"S613","DOI":"10.1016\/j.annonc.2024.08.909","article-title":"Phase II study of trastuzumab deruxtecan in patients with HER2-positive recurrent\/metastatic salivary gland cancer: results from the MYTHOS trial (jRCT2011210017)","volume":"35","author":"Kinoshita","year":"2024","journal-title":"Ann Oncol"},{"key":"2026082404150536000_19.8.e269218.19","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz291"},{"key":"2026082404150536000_19.8.e269218.20","doi-asserted-by":"crossref","unstructured":"Ross J , Bob TL , Schoch L , et al . A phase 2 basket trial of ado-trastuzumab emtansine for patients with HER2-amplified salivary gland cancers. 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