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Successful Neoadjuvant Treatment Using Trastuzumab Emtansine (Kadcyla) for Locally Advanced and Metastatic Lacrimal

Agni Kakouri1,2, Matthew J Debnam3, Renata Ferrarotto4

  • 1Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center.

Ophthalmic Plastic and Reconstructive Surgery
|May 7, 2025
PubMed

Insights

Neoadjuvant trastuzumab emtansine effectively treated advanced HER2-positive lacrimal gland adenocarcinoma with parotid metastasis. This therapy enabled eye-sparing surgery and avoided extensive procedures like parotidectomy.

Area of Science:

  • Oncology
  • Ophthalmology
  • Medical Oncology

Background:

  • Locally advanced lacrimal gland adenocarcinoma is a rare malignancy.
  • HER2-positive status in lacrimal gland tumors presents a therapeutic target.
  • Metastasis to the parotid gland complicates treatment and prognosis.

Purpose of the Study:

  • To evaluate the efficacy of neoadjuvant trastuzumab emtansine in a patient with advanced HER2-positive lacrimal gland adenocarcinoma.
  • To assess the impact of this therapy on surgical options and patient outcomes.

Main Methods:

  • A 25-year-old male patient with locally advanced lacrimal gland adenocarcinoma and parotid metastasis was identified.
  • Tumor HER2 positivity (3+) was confirmed via immunohistochemistry.
  • Neoadjuvant therapy with trastuzumab emtansine was administered.

Main Results:

  • The patient demonstrated an excellent response to neoadjuvant trastuzumab emtansine.
  • Significant tumor size reduction in the lacrimal gland was observed, facilitating eye-sparing surgery.
  • Near-complete resolution of parotid metastasis occurred, avoiding radical neck dissection and parotidectomy.

Conclusions:

  • Neoadjuvant trastuzumab emtansine is a highly effective treatment for HER2-positive advanced lacrimal gland adenocarcinoma.
  • This targeted therapy can downstage tumors, enabling less invasive surgical approaches.
  • Trastuzumab emtansine offers a promising therapeutic strategy for HER2-driven lacrimal gland malignancies.

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