P B De Ieso1, U Schick2, N Rosenfelder2, K Mohammed2, G M Ross2. 1. Breast Clinical Oncology Unit, The Royal Marsden NHS Foundation Trust, Sutton and London, UK; NT Radiation Oncology, Alan Walker Cancer Centre, Rocklands Drive, Tiwi, NT 0810, Australia. Electronic address: paolo.deieso@nt.gov.au. 2. Breast Clinical Oncology Unit, The Royal Marsden NHS Foundation Trust, Sutton and London, UK.
Abstract
BACKGROUND: Breast cancer (BC) is the 2nd commonest cause of brain metastases (BM). This retrospective review investigates the applicability of prognostic scores and highlights different outcomes for patients with HER2 positive compared to triple negative (TN) subtypes. METHODS: Two hundred and seventy four patients received whole brain radiotherapy for BC BM (01/2000-12/2011). The primary objective was to determine factors influencing overall survival (OS). All information relevant to primary BC, disease recurrence, treatment, outcome and cause of death (either neurological (NP) or systemic progression (SP)) were collected. Univariate (UV) and multivariate (MV) Cox regression analysis were used. RESULTS: One hundred and forty four patients (53%) were ER positive, 104 (38%) HER2 positive and 57 (21%) TN. Median age at BM was 53 (27-81) years and median OS from BM diagnosis 7.3 (5.7-8.9) months. On MV analysis, Her2 status, RPA score, surgery, stereotactic radiotherapy, and absence of TN disease were independent prognostic factor for OS. NP was the cause of death in 69.2% of HER2 positive patients and 17.3% had SP. Of the TN patients, 29.8% had NP and 54.4% SP (p < 0.001). CONCLUSION: A consistent OS advantage is noted for HER2 positive BM cases and inclusion of BC subtype in the breast GPA score should improve the prognostic factors' sensitivity. The unique presentations, response to treatment and causes of death for HER2 positive patients means more aggressive focal therapy should be considered and studied in the context of clinical trials. For TN BM patients with poor performance status, best supportive care may be appropriate. Crown
BACKGROUND:Breast cancer (BC) is the 2nd commonest cause of brain metastases (BM). This retrospective review investigates the applicability of prognostic scores and highlights different outcomes for patients with HER2 positive compared to triple negative (TN) subtypes. METHODS: Two hundred and seventy four patients received whole brain radiotherapy for BC BM (01/2000-12/2011). The primary objective was to determine factors influencing overall survival (OS). All information relevant to primary BC, disease recurrence, treatment, outcome and cause of death (either neurological (NP) or systemic progression (SP)) were collected. Univariate (UV) and multivariate (MV) Cox regression analysis were used. RESULTS: One hundred and forty four patients (53%) were ER positive, 104 (38%) HER2 positive and 57 (21%) TN. Median age at BM was 53 (27-81) years and median OS from BM diagnosis 7.3 (5.7-8.9) months. On MV analysis, Her2 status, RPA score, surgery, stereotactic radiotherapy, and absence of TN disease were independent prognostic factor for OS. NP was the cause of death in 69.2% of HER2 positive patients and 17.3% had SP. Of the TN patients, 29.8% had NP and 54.4% SP (p < 0.001). CONCLUSION: A consistent OS advantage is noted for HER2 positive BM cases and inclusion of BC subtype in the breast GPA score should improve the prognostic factors' sensitivity. The unique presentations, response to treatment and causes of death for HER2 positive patients means more aggressive focal therapy should be considered and studied in the context of clinical trials. For TN BM patients with poor performance status, best supportive care may be appropriate. Crown
Authors: Amy N Melsaether; Roy A Raad; Akshat C Pujara; Fabio D Ponzo; Kristine M Pysarenko; Komal Jhaveri; James S Babb; Eric E Sigmund; Sungheon G Kim; Linda A Moy Journal: Radiology Date: 2016-03-29 Impact factor: 11.105
Authors: Leticia De Mattos-Arruda; Charlotte K Y Ng; Salvatore Piscuoglio; Maria Gonzalez-Cao; Raymond S Lim; Maria R De Filippo; Nicola Fusco; Anne M Schultheis; Carolina Ortiz; Santiago Viteri; Alexandra Arias; Gabriel S Macedo; Mafalda Oliveira; Patricia Gomez; Cristina Teixidó; Paolo Nuciforo; Vicente Peg; Cristina Saura; Santiago Ramon Y Cajal; Francesc Tresserra Casas; Britta Weigelt; Javier Cortes; Joan Seoane; Jorge S Reis-Filho Journal: Oncotarget Date: 2018-04-17