The Clinical Utilisation and Duration of Treatment with HER2-Directed Therapies in HER2-Positive Recurrent or Metastatic Salivary Gland Cancers
, Karan Patel 1, Sam Rack 1, Pablo Jiménez-Labaig 2,3,4, Guy Betts 5, Kevin Joseph Harrington 2,4 and Robert Metcalf 1,*
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsThe article presents a very interesting topic about the treatment of recurrent or metastatic salivary gland cancer with HER2-directed therapies in the UK. The article is well written, but an increase in content is advisable.
It would be beneficial to include the epidemiology of salivary gland tumors, including the percentage of malignant tumors and the trend of incidence in recent years, in the introduction of the manuscript.
Please remove the following phrases from the Materials and Methods section: "Objectives," "Design and Setting," "Participants and Outcome Measures," and "Ethical Considerations."
Please provide a more detailed description of the MRI scans, including the time period of the scan in photos 3c and d.
It would be beneficial to expand the article's discussion. Please provide a description of the results of the current standard treatment for recurrent or metastatic salivary gland cancers and a comparison with the results of clinical trials using HER2-directed therapies.
Please provide a more detailed description of the histological types of salivary gland carcinomas that are characterized by HER2 expression. Is HER2 expression different in different histological subtypes of carcinoma ex pleomorphic adenoma?
Please provide further details on the treatment of HER2-positive patients with other types of cancer, including breast cancer, gastrointestinal cancers, ovarian cancer, and stomach cancer.
Please include a section on study limitations at the end of the discussion, along with a description of future study perspectives.
Please increase the number of references according to the comments posted above.
Comments on the Quality of English LanguageMinor editing of English language required
Author Response
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Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsThe author said that this paper is related to real-world date setting of HER-2 directed therapies. I feel that if the author mentioned that this paper would be related to the real-world data of that, he should use true real-world data not only in UK but also another countries also more time duration of that because this paper’s case was only 18.
Author Response
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Author Response File: Author Response.pdf
Reviewer 3 Report
Comments and Suggestions for AuthorsI congratulate the authors for this interesting manuscript on the clinical utilization and duration on treatment with HER2-directed therapies in HER2-positive recurrent or metastatic salivary gland cancers. The series of patients with unresectable recurrences of salivary carcinomas treated with this therapy is quite large and the results are encouraging. I agree with the authors that it is appropriate to perform screening for HER2-positivity in these patients so that those who are positive can be subjected to this palliative but sometimes very effective therapy.
I just have one small observation to make.
On line 116 the authors write: "“They received six cycles…”. It seems to me that “They” should be corrected to “He or She”. However, it could be a grammatical error on my part as I am not a native English speaker.
Author Response
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Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
Comments and Suggestions for AuthorsThank you for addressing the issues previously identified in the article. The article can be accepted in its current form.
