Carcinoma of the lacrimal gland is a rare
malignancy, limiting opportunities to develop new therapeutic regimens through clinical trials. There are no standard guidelines on optimal treatment of lacrimal gland
carcinoma. In addition, lacrimal gland
carcinoma includes several different subtypes with distinct behavior and response to treatment, further complicating treatment. Overexpression of the Her-2/neu
protein, a potential target for new therapeutic agents, has previously been described in lacrimal gland
carcinoma; however, there are no published reports regarding treatment of lacrimal gland
cancer with Her-2 directed medications. This case report describes treatment of a patient with metastatic lacrimal gland
carcinoma with
lapatinib, an oral agent with activity against Her-2/neu amplified
malignancies. In this case, Her-2 overexpression was confirmed by biopsy of a metastatic site. PET imaging obtained 6 months after the initiation of
lapatinib showed evidence of a partial response to treatment, although the patient later developed progressive neurologic complications related to her
malignancy and ultimately died.
Lapatinib and other Her-2 targeted agents may represent an effective therapeutic option for this rare
malignancy, in cases of metastatic disease.