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Successful human epidermal growth receptor 2-targeted therapy beyond disease progression for extramammary Paget’s disease

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Summary

Extramammary Paget’s disease is a malignant intraepithelial carcinoma, which constitutes less than 1 % of all vulvar malignancies. Surgical resection is the first treatment of choice and standard chemotherapy has not been established for advanced or recurrent disease. Experimental and clinical studies have identified human epidermal growth receptor 2 as a potential therapeutic target. A 63-year-old male was referred for recurrent extramammary Paget’s disease after surgery. Human epidermal growth receptor 2 was shown to be overexpressed and amplified by immunohistochemical analysis and fluorescence in situ hybridization analysis, respectively. After two cycles of trastuzumab monotherapy, all lymph node metastases decreased in size. However, he experienced recurrence in the lymph nodes during the seven courses of trastuzumab. As a subsequent treatment, trastuzumab was administered in combination with docetaxel and pertuzumab; clinical response was sustained for 12 months without significant adverse events.

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References

  1. Parker LP, Parker JR, Bodurka-Bevers D et al (2000) Paget’s disease of the vulva: pathology, pattern of involvement, and prognosis. Gynecol Oncol 77:183–189

    Article  CAS  PubMed  Google Scholar 

  2. Fanning J, Lambert HC, Hale TM et al (1999) Paget’s disease of the vulva: prevalence of associated vulvar adenocarcinoma, invasive Paget’s disease, and recurrence after surgical excision. Am J Obstet Gynecol 180:24–27

    Article  CAS  PubMed  Google Scholar 

  3. Tebes S, Cardosi R, Hoffman M (2002) Paget’s disease of the vulva. Am J Obstet Gynecol 187:281–283, discussion 283–284

    Article  PubMed  Google Scholar 

  4. Tokuda Y, Arakura F, Uhara H (2015) Combination chemotherapy of low-dose 5-fluorouracil and cisplatin for advanced extramammary Paget’s disease. Int J Clin Oncol 20:194–197

    Article  CAS  PubMed  Google Scholar 

  5. Oashi K, Tsutsumida A, Namikawa K et al (2014) Combination chemotherapy for metastatic extramammary Paget disease. Br J Dermatol 170:1354–1357

    Article  CAS  PubMed  Google Scholar 

  6. Brummer O, Stegner HE, Bohmer G et al (2004) HER-2/neu expression in Paget disease of the vulva and the female breast. Gynecol Oncol 95:336–340

    Article  CAS  PubMed  Google Scholar 

  7. Richter CE, Hui P, Buza N et al (2010) HER-2/NEU overexpression in vulvar Paget disease: the Yale experience. J Clin Pathol 63:544–547

    Article  CAS  PubMed  Google Scholar 

  8. Barth P, Dulaimi Al-Saleem E, Edwards KW et al (2015) Metastatic extramammary Paget’s disease of scrotum responds completely to single agent Trastuzumab in a hemodialysis patient: case report molecular profiling and brief review of the literature. Case Rep Oncol Med 2015:895151

    PubMed  PubMed Central  Google Scholar 

  9. Wakabayashi S, Togawa Y, Yoneyama K et al (2012) Dramatic clinical response of relapsed metastatic extramammary Paget’s disease to Trastuzumab Monotherapy. Case Rep Dermatol Med 2012:401362

    CAS  PubMed  PubMed Central  Google Scholar 

  10. von Minckwitz G, du Bois A, Schmidt M et al (2009) Trastuzumab beyond progression in human epidermal growth factor receptor 2-positive advanced breast cancer: a German breast group 26/breast international group 03–05 study. J Clin Oncol 27:1999–2006

    Article  Google Scholar 

  11. Swain SM, Kim SB, Cortes J et al (2013) Pertuzumab, Trastuzumab, and docetaxel for HER2-positive metastatic breast cancer (CLEOPATRA study): overall survival results from a randomised, double-blind, placebo-controlled, phase 3 study. Lancet Oncol 14:461–471

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This study was supported in part by JSPS KAKENHI Grant Number 15 K21525, Uehara Memorial Foundation, and Takeda Science Foundation.

Authors’ contributions

SW and MT were responsible for clinical management of the patient, acquisition of data, and drafting the manuscript; TI, TT, JT, YW, NI, JT, TS, KS, KN and KN were responsible for interpretation of data and critical revision of the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Medical Oncology, Kinki University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka, 589-8511, Japan

    Satomi Watanabe, Masayuki Takeda, Takayuki Takahama, Tsutomu Iwasa, Junji Tsurutani, Junko Tanizaki, Toshio Shimizu & Kazuhiko Nakagawa

  2. Department of Genome Biology, Kinki University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka, 589-8511, Japan

    Kazuko Sakai & Kazuto Nishio

  3. Department of Plastic and Reconstructive Surgery, Kinki University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka, 589-8511, Japan

    Yoshitaka Wada & Noritaka Isogai

Authors
  1. Satomi Watanabe
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  2. Masayuki Takeda
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  3. Takayuki Takahama
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  4. Tsutomu Iwasa
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  5. Junji Tsurutani
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  6. Junko Tanizaki
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  7. Toshio Shimizu
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  8. Kazuko Sakai
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  9. Yoshitaka Wada
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  10. Noritaka Isogai
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  11. Kazuto Nishio
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  12. Kazuhiko Nakagawa
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Corresponding author

Correspondence to Masayuki Takeda.

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Patient consent

Written informed consent was obtained from the patient for publication of this case report and accompanying images before the patient received chemotherapy.

Conflict Interest

Kazuhiko Nakagawa received honoraria from Chugai pharmaceuticals.

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Watanabe, S., Takeda, M., Takahama, T. et al. Successful human epidermal growth receptor 2-targeted therapy beyond disease progression for extramammary Paget’s disease. Invest New Drugs 34, 394–396 (2016). https://doi.org/10.1007/s10637-016-0329-8

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  • DOI: https://doi.org/10.1007/s10637-016-0329-8

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