David Pasquier1, Amélie Darlix2, Guillaume Louvel3, Julien Fraisse4, William Jacot5, Etienne Brain6, Adeline Petit7, Marie Ange Mouret-Reynier8, Anthony Goncalves9, Florence Dalenc10, Elise Deluche11, Jean Sébastien Fresnel12, Paule Augereau13, Jean Marc Ferrero14, Julien Geffrelot15, Jean-David Fumet16, Isabelle Lecouillard17, Paul Cottu6, Thierry Petit18, Lionel Uwer19, Christelle Jouannaud20, Marianne Leheurteur21, Véronique Dieras17, Mathieu Robain22, Raphaelle Mouttet-Audouard23, Thomas Bachelot24, Coralie Courtinard22. 1. Academic Department of Radiation Oncology, Centre Oscar Lambret, 3 Rue Frédéric Combemale, 59000, Lille, France; CRIStAL UMR CNRS 9189, Lille University, Avenue Carl Gauss, F-59650, Villeneuve-d'Ascq, France. Electronic address: d-pasquier@o-lambret.fr. 2. Department of Medical Oncology, Institut Régional Du Cancer de Montpellier (ICM), University of Montpellier, 208 Rue des Apothicaires, 34298, Montpellier, France. 3. Department of Radiation Therapy, Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France. 4. Biometrics Unit, Institut Du Cancer de Montpellier, 208 Rue des Apothicaires, 34298, Montpellier, France. 5. Department of Medical Oncology, Institut Régional Du Cancer de Montpellier (ICM), University of Montpellier, 208 Rue des Apothicaires, 34298, Montpellier, France; Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM U1194, Institut Du Cancer de Montpellier, University of Montpellier 208 Rue des Apothicaires, 34298, Montpellier, France. 6. Department of Medical Oncology, Institut Curie, 26 Rue D'Ulm, 75005, Paris & Saint-Cloud, France. 7. Department of Radiation Oncology, Institut Bergonié, Bordeaux, France. 8. Department of Medical Oncology, Centre Jean Perrin, 58 Rue Montalembert, 63011, Clermont Ferrand, France. 9. Department of Medical Oncology, Institut Paoli-Calmettes, 232 Boulevard de Sainte-Marguerite, 13009, Marseille, France. 10. Department of Medical Oncology, Institut Claudius Regaud - IUCT Oncopole, 1 Avenue Irène- Joliot-Curie, 31059, Toulouse, France. 11. Department of Cancer Medicine, Institut Gustave Roussy, 114 Rue Edouard-Vaillant, 94805, Villejuif, France. 12. Department of Medical Oncology, Institut de Cancérologie de L'Ouest Centre René Gauducheau, Boulevard Jacques Monod, 44805, Saint Herblain, France. 13. Department of Medical Oncology, Institut de Cancérologie de L'Ouest, 15 Rue André Boquel, 49055, Angers, France. 14. Department of Medical Oncology, Centre Antoine Lacassagne, 33 Avenue de Valambrose, 06189, Nice, France. 15. Department of Radiation Oncology, Centre François Baclesse, 3 Avenue Du Général Harris, 14000, Caen, France. 16. Department of Medical Oncology, Centre Georges François Leclerc, 1 Rue Professeur Marion, 21079, Dijon, France. 17. Medical Oncology Department, Centre Eugène Marquis, Avenue de La Bataille Flandres- Dunkerque, 35000, Rennes, France. 18. Department of Medical Oncology, Centre Paul Strauss, 3 Rue de La Porte de L'Hôpital, 67000, Strasbourg, France. 19. Medical Oncology Department, Institut de Cancérologie de Lorraine, 6 Avenue de Bourgogne, 54519, Vandoeuvre-lès-Nancy, France. 20. Department of Medical Oncology, Institut de Cancérologie Jean-Godinot, 1 Rue Du Général, Koenig, 51100, Reims, France. 21. Department of Medical Oncology, Centre Henri Becquerel, Rue D'Amiens, 76000, Rouen, France. 22. Department of Research and Development, Unicancer, 101 Rue de Tolbiac, 75654, Paris, France. 23. Academic Department of Radiation Oncology, Centre Oscar Lambret, 3 Rue Frédéric Combemale, 59000, Lille, France. 24. Department of Medical Oncology, Centre Léon Bérard, 28 Promenade Léa et Napoléon Bullukian, 69008, Lyon, France.
Abstract
AIM: The aims of the present study were to describe treatment patterns and survival outcomes in patients with central nervous system metastases (CNSM) selected among metastatic breast cancer (MBC) patients included in a retrospective study from the Epidemiological Strategy and Medical Economics (ESME) MBC cohort. METHODS: Neurological progression-free survival (NPFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Significant contributors to NPFS were determined using a multivariate Cox proportional hazards model. RESULTS: After a median follow-up of 42.8 months, of 16 701 patients included in the ESME MBC database, CNSM were diagnosed in 24.6% of patients. The most frequent treatments after diagnosis of CNSM were whole-brain radiotherapy (WBRT) (45.2%) and systemic treatment (59.3%). Median OS and NPFS were 7.9 months (95% CI: 7.2-8.4) and 5.5 months (95% CI: 5.2-5.8), respectively. In multivariate analysis, age >70 years (vs <50 years; HR = 1.40; 95% CI: 1.24-1.57), triple-negative tumours (vs HER2-/HR+; HR = 1.87; 95% CI: 1.71-2.06), HER2+/HR-tumours (vs HER2-/HR+; HR = 1.14; 95% CI: 1.02-1.27), ≥3 metastatic sites (vs < 3; HR = 1.32; 95% CI: 1.21-1.43) and ≥3 previous treatment lines (vs < 3; HR = 1.75; 95% CI: 1.56-1.96) were detrimental for NPFS. A time interval between selection and CNSM diagnosis superior to 18 months (vs <9 months; HR = 0.88; 95% CI: 0.78-0.98) was associated with longer NPFS. CONCLUSIONS: This study describes current treatment patterns of MBC patients in a "real life" setting. Despite advances in stereotactic radiation therapy, most of the patients still received WBRT. More research is warranted to identify patient subsets for tailored treatment strategies.
AIM: The aims of the present study were to describe treatment patterns and survival outcomes in patients with central nervous system metastases (CNSM) selected among metastatic breast cancer (MBC) patients included in a retrospective study from the Epidemiological Strategy and Medical Economics (ESME) MBC cohort. METHODS: Neurological progression-free survival (NPFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Significant contributors to NPFS were determined using a multivariate Cox proportional hazards model. RESULTS: After a median follow-up of 42.8 months, of 16 701 patients included in the ESME MBC database, CNSM were diagnosed in 24.6% of patients. The most frequent treatments after diagnosis of CNSM were whole-brain radiotherapy (WBRT) (45.2%) and systemic treatment (59.3%). Median OS and NPFS were 7.9 months (95% CI: 7.2-8.4) and 5.5 months (95% CI: 5.2-5.8), respectively. In multivariate analysis, age >70 years (vs <50 years; HR = 1.40; 95% CI: 1.24-1.57), triple-negative tumours (vs HER2-/HR+; HR = 1.87; 95% CI: 1.71-2.06), HER2+/HR-tumours (vs HER2-/HR+; HR = 1.14; 95% CI: 1.02-1.27), ≥3 metastatic sites (vs < 3; HR = 1.32; 95% CI: 1.21-1.43) and ≥3 previous treatment lines (vs < 3; HR = 1.75; 95% CI: 1.56-1.96) were detrimental for NPFS. A time interval between selection and CNSM diagnosis superior to 18 months (vs <9 months; HR = 0.88; 95% CI: 0.78-0.98) was associated with longer NPFS. CONCLUSIONS: This study describes current treatment patterns of MBC patients in a "real life" setting. Despite advances in stereotactic radiation therapy, most of the patients still received WBRT. More research is warranted to identify patient subsets for tailored treatment strategies.
Authors: Aki Morikawa; Milan Grkovski; Sujata Patil; Komal L Jhaveri; Kendrick Tang; John L Humm; Andrei Holodny; Kathryn Beal; Heiko Schöder; Andrew D Seidman Journal: Breast Cancer Res Treat Date: 2021-06-10 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: E Laakmann; I Witzel; T Neunhöffer; T-W Park-Simon; R Weide; K Riecke; A Polasik; M Schmidt; J Puppe; C Mundhenke; K Lübbe; T Hesse; M Thill; D-M Zahm; C Denkert; T Fehm; V Nekljudova; J Rey; S Loibl; V Müller Journal: ESMO Open Date: 2022-05-30
Authors: Xin Ye Wang; Michael N Rosen; Rania Chehade; Arjun Sahgal; Sunit Das; Ellen Warner; Refik Saskin; Bo Zhang; Hany Soliman; Kelvin K W Chan; Katarzyna J Jerzak Journal: JAMA Netw Open Date: 2022-08-01