Cancer Management and Research (Nov 2021)

Characterization of Treatments and Disease Course for Women with Breast Cancer Brain Metastases: 5-Year Retrospective Single Institution Experience

  • Chew S,
  • Carroll HK,
  • Darwish W,
  • Boychak O,
  • Higgins M,
  • McCaffrey J,
  • Kelly CM

Journal volume & issue
Vol. Volume 13
pp. 8191 – 8198

Abstract

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Sonya Chew,1 Hailey Kathryn Carroll,1 Waseem Darwish,1 Oleksandr Boychak,2 Michaela Higgins,1 John McCaffrey,1 Catherine Margaret Kelly1 1Department of Medical Oncology, Mater Misericordiae University Hospital, Dublin, Ireland; 2Department of Radiation Oncology, St Luke’s Radiation Oncology Network, Beaumont Hospital, Dublin, IrelandCorrespondence: Sonya ChewMater Misericordiae University Hospital, Eccles Street, Dublin 7, Dublin, D07R2WY, IrelandTel +35318032000Fax +35318032113Email [email protected]: Around 30% of patients with breast cancer will develop brain metastases (BM). We sought to characterize the disease course, treatments and outcome for our patient cohort.Materials and Methods: We extracted clinicopathological data from electronic records from January 2015 to December 2020. Results were generated using SPSS statistics v27.Results: We identified 98 patients. Median overall survival (OS) from BM diagnosis was 3 months [hormone receptor (HR)+/human epidermal growth factor receptor 2 (HER2)–], 8 months [HR+/HER2+], 7 months [HR–/HER2+] and 2 months [triple negative breast cancer (TNBC)]. Whole brain radiotherapy (WBRT) (n=48, 70%) was most frequently used followed by surgery (n=15, 22%) and stereotactic radiosurgery (n=6, 8%). In patients who received WBRT alone (n=40) the median OS post WBRT was 2.6 months.Conclusion: After BM development, half of the patients had systemic therapy and 70% had local therapy, but only the HER2 subgroup had a prolonged OS likely reflecting central nervous system (CNS) activity of anti-HER2 drugs. TNBC patients had the worst prognosis. Although our cohort is small, OS was > 1 year for 60% of HER2+ patients who received trastuzumab emtansine after BM development, which is encouraging for antibody drug conjugates and CNS activity. Patients who received WBRT had a higher burden of CNS disease and had an OS of less than 3 months.Keywords: metastatic, breast cancer, brain metastases, treatment, triple negative

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