4.7 Article

Leptomeningeal metastases in patients with human epidermal growth factor receptor 2 positive breast cancer: Real-world data from a multicentric European cohort

Journal

INTERNATIONAL JOURNAL OF CANCER
Volume 151, Issue 8, Pages 1355-1366

Publisher

WILEY
DOI: 10.1002/ijc.34135

Keywords

anti-HER2 therapy; breast cancer; human epidermal growth factor receptor 2; leptomeningeal metastases; radiation therapy

Categories

Funding

  1. Conquer Cancer Foundation of ASCO/Shanken Family Foundation Young Investigator Award
  2. Fondazione AIRC under 5 per mille 2019 [22759]
  3. Istituto Oncologico Veneto Projects [L02P03, L04P11, L04P25]
  4. University of Padova -Department of Surgery, Oncology and Gastroenterology

Ask authors/readers for more resources

Leptomeningeal metastases (LM) in patients with HER2+ breast cancer are rare but often fatal. This multicentric study retrospectively gathered data from 82 patients with advanced HER2+ breast cancer and LM. The study found that absence of neurological symptoms and receiving radiotherapy were associated with prolonged overall survival.
In patients with human epidermal growth factor receptor 2 positive (HER2+) breast cancer, leptomeningeal metastases (LM) are a rare but often a fatal clinical scenario. In this multicentric study, clinical and pathologic characteristics of patients with HER2+ breast cancer developing LM were described, as well as survival outcomes. Data were gathered retrospectively from medical records of 82 patients with advanced HER2+ breast cancer and LM treated between August 2005 and July 2020. Following LM diagnosis, 79 (96.3%) patients received at least one line of anti-HER2 therapy, 25 (30.5%) patients received intrathecal therapy and 58 (70.7%) patients received radiotherapy. Overall survival (OS) was 8.3 months (95% confidence interval [CI] 5.7-11), 1-year OS was 42%, and 2-year OS was 21%. At univariate analysis, patients who were treated after 2010, had better Karnofsky performance status, were free of neurological symptoms, had better prognostic, received chemotherapy (OS difference 9.4 months, P = .024), or monoclonal antibodies (trastuzumab +/- pertuzumab; OS difference 6.1 months; P = .013) after LM diagnosis, had a statistically significantly longer OS. Presence of neurological symptoms (hazard ratio 3.32, 95% CI 1.26-8.73; P = .015) and not having received radiotherapy (hazard ratio 2.02, 95% CI 1.09-3.72; P = .024) were all associated with poorer OS at multivariate analysis. To summarize, not having neurological symptoms and receiving RT at LM diagnosis were associated with prolonged OS in our cohort. Survival seemed to be prolonged with multimodality treatment, which included targeted therapy, chemotherapy, and RT to the LM sites.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.7
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available