I Witzel1, E Laakmann2, R Weide3, T Neunhöffer4, T-J Park-Simon5, M Schmidt6, P A Fasching7, T Hesse8, A Polasik9, S Mohrmann10, F Würschmidt11, C Schem12, C Bechtner13, R Würstlein14, T Fehm15, V Möbus16, N Burchardi17, S Loibl18, V Müller19. 1. University Medical Center Hamburg-Eppendorf, Department of Gynecology, Hamburg, Germany. Electronic address: iwitzel@uke.de. 2. University Medical Center Hamburg-Eppendorf, Department of Gynecology, Hamburg, Germany. Electronic address: e.laakmann@uke.de. 3. Oncological Outpatient Department, Koblenz, Germany. Electronic address: weide@onkologie-koblenz.de. 4. HELIOS Dr. Horst Schmidt Clinic Wiesbaden, Wiesbaden, Germany. Electronic address: Tanja.Neunhoeffer@helios-gesundheit.de. 5. Hannover Medical School, Department of Gynecology, Hannover, Germany. Electronic address: Park-Simon.tjoung-won@mh-hannover.de. 6. Department of Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Germany. Electronic address: marcus.schmidt@unimedizin-mainz.de. 7. Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany. Electronic address: Peter.Fasching@uk-erlangen.de. 8. Agaplesion Diakonie Clinic Rotenburg, Department of Gynecology, Rotenburg, Germany. Electronic address: Hesse@diako-online.de. 9. Department of Gynecology and Obstetrics, University Medical Center Ulm, Germany. Electronic address: arkadius.polasik@uniklinik-ulm.de. 10. Duesseldorf University Hospital, Department of Gynecology, Duesseldorf, Germany. Electronic address: svjetlana.mohrmann@med.uni-duesseldorf.de. 11. Radiologische Allianz Hamburg, Hamburg, Germany. Electronic address: florian.wuerschmidt@radiologische-allianz.de. 12. University Medical Center-UKSH, Department of Gynecology, Kiel, Germany; Mammazentrum, Krankenhaus Jerusalem, Hamburg, Germany. Electronic address: schem@mammazentrum.eu. 13. Frauenklinik, Memmingen Hospital, Germany. Electronic address: christina.bechtner@klinikum-memmingen.de. 14. Department of Gynecology and Obstetrics, Ludwig-Maximilian-University Munich, Germany. Electronic address: Rachel.Wuerstlein@med.uni-muenchen.de. 15. Translational Research Board of the Gynecological Oncology Working Group (AGO-Trafo), Germany. Electronic address: tanja.fehm@med.uni-duesseldorf.de. 16. Breast Study Group of the Gynecological Oncology Working Group (AGO-B), Germany. Electronic address: Volker.Moebus@KlinikumFrankfurt.de. 17. German Breast Group GmbH, Neu-Isenburg, Germany. Electronic address: Nicole.Burchardi@gbg.de. 18. German Breast Group GmbH, Neu-Isenburg, Germany. Electronic address: sibylle.loibl@gbg.de. 19. University Medical Center Hamburg-Eppendorf, Department of Gynecology, Hamburg, Germany. Electronic address: vmueller@uke.de.
Abstract
BACKGROUND: Brain metastases (BMs) have a major impact on life expectancy and quality of life for many breast cancer patients. Knowledge about treatment patterns and outcomes is limited. METHODS: We analysed clinical data of 1712 patients diagnosed with BMs from breast cancer between January 2000 and December 2016 at 80 institutions. RESULTS: Median age at diagnosis of BMs was 56 years (22-90 years). About 47.8% (n = 732) of patients had HER2-positive, 21.4% (n = 328) had triple-negative and 30.8% (n = 471) had hormone receptor (HR)-positive, HER2-negative (luminal-like) primary tumours. The proportion of patients with HER2-positive BMs decreased comparing the years 2000-2009 with 2010-2015 (51%-44%), whereas the percentage of patients with luminal-like tumours increased (28%-34%; p = 0.0331). Patients with BMs in the posterior fossa were more often HER2 positive (n = 169/314, 53.8%) than those diagnosed with triple-negative (n = 65/314, 20.7%) or luminal-like primary breast cancer (n = 80/314, 25.5%), (p < 0.0001). Median overall survival (OS) time after development of BMs for the overall cohort was 7.4 months (95% confidence interval [CI]: 6.7-8.0 months). One-year survival rate was 37.7% (95% CI: 35.2-40.1). Patients with HER2-positive tumours had the longest median OS of 11.6 months (95% CI: 10.0-13.4) compared with 5.9 months (95% CI: 5.0-7.2) for patients with luminal-like and 4.6 months (95% CI: 3.9-5.4) for patients with triple-negative tumours. Patients with HER2-positive tumours who received anti-HER2 treatment had longer median OS than those without (17.1 months versus 7.2 months, p < 0.0001). CONCLUSIONS: Prognosis of patients after developing BMs varies significantly according to the subtype. The outcome in this cohort is similarly poor in triple-negative and HR-positive/HER2-negative patients. Our results underline the high medical need for improvement of treatment and prevention strategies for BMs in breast cancer patients.
BACKGROUND: Brain metastases (BMs) have a major impact on life expectancy and quality of life for many breast cancerpatients. Knowledge about treatment patterns and outcomes is limited. METHODS: We analysed clinical data of 1712 patients diagnosed with BMs from breast cancer between January 2000 and December 2016 at 80 institutions. RESULTS: Median age at diagnosis of BMs was 56 years (22-90 years). About 47.8% (n = 732) of patients had HER2-positive, 21.4% (n = 328) had triple-negative and 30.8% (n = 471) had hormone receptor (HR)-positive, HER2-negative (luminal-like) primary tumours. The proportion of patients with HER2-positive BMs decreased comparing the years 2000-2009 with 2010-2015 (51%-44%), whereas the percentage of patients with luminal-like tumours increased (28%-34%; p = 0.0331). Patients with BMs in the posterior fossa were more often HER2 positive (n = 169/314, 53.8%) than those diagnosed with triple-negative (n = 65/314, 20.7%) or luminal-like primary breast cancer (n = 80/314, 25.5%), (p < 0.0001). Median overall survival (OS) time after development of BMs for the overall cohort was 7.4 months (95% confidence interval [CI]: 6.7-8.0 months). One-year survival rate was 37.7% (95% CI: 35.2-40.1). Patients with HER2-positive tumours had the longest median OS of 11.6 months (95% CI: 10.0-13.4) compared with 5.9 months (95% CI: 5.0-7.2) for patients with luminal-like and 4.6 months (95% CI: 3.9-5.4) for patients with triple-negative tumours. Patients with HER2-positive tumours who received anti-HER2 treatment had longer median OS than those without (17.1 months versus 7.2 months, p < 0.0001). CONCLUSIONS: Prognosis of patients after developing BMs varies significantly according to the subtype. The outcome in this cohort is similarly poor in triple-negative and HR-positive/HER2-negative patients. Our results underline the high medical need for improvement of treatment and prevention strategies for BMs in breast cancerpatients.
Authors: Matthew N Mills; Thrisha K Potluri; Yuki Kawahara; Matthew Fahey; Nicholas B Figura; Aixa E Soyano; Iman R Washington; Roberto Diaz; Daniel E Oliver; Hsiang-Hsuan Michael Yu; Arnold B Etame; Michael A Vogelbaum; Brian J Czerniecki; John A Arrington; Solmaz Sahebjam; Peter A Forsyth; Hatem H Soliman; Hyo S Han; Kamran A Ahmed Journal: Breast Cancer Res Treat Date: 2021-10-20 Impact factor: 4.872
Authors: Yizhuo Kelly Gao; Markus Kuksis; Badr Id Said; Rania Chehade; Alex Kiss; William Tran; Faisal Sickandar; Arjun Sahgal; Ellen Warner; Hany Soliman; Katarzyna J Jerzak Journal: Oncologist Date: 2021-09-21
Authors: Jayendrakishore Tanjore Ramanathan; Suvi Lehtipuro; Harri Sihto; József Tóvári; Lilla Reiniger; Vanda Téglási; Judit Moldvay; Matti Nykter; Hannu Haapasalo; Vadim Le Joncour; Pirjo Laakkonen Journal: J Cell Mol Med Date: 2020-05-11 Impact factor: 5.310