Brain metastases in Asian HER2-positive breast cancer patients: anti-HER2 treatments and their impact on survival

Abstract

Background:In Asia, large-scale studies on anti-HER2 treatment in HER2-positive breast cancer patients with brain metastases are limited. We studied the treatment patterns of these patients in Asia to evaluate the impact of anti-HER2 treatment on the time to occurrence of brain metastases (TTBM) and survival after brain metastasis (BM).Methods:A retrospective study of HER2-positive breast cancer patients diagnosed with BM between January 2006 and December 2008 in six Asian countries was conducted. Demographics, tumour characteristics, treatment details, and events dates were collected from medical records.Results:Data from 280 patients were analysed. Before BM, 63% received anti-HER2 treatment. These patients had significantly longer TTBM than those without anti-HER2 treatment (median 33 vs 19 months; P<0.002). After BM, 93% received radiotherapy, 57% received chemotherapy, and 41% received anti-HER2 treatment (trastuzumab and/or lapatinib). Use of both anti-HER2 agents, primarily sequentially, after BM demonstrated the longest survival after BM and was associated with a significant survival benefit over no anti-HER2 treatment (median 26 vs 6 months; hazard ratio 0.37; 95% CI 0.19–0.72).Conclusion:Anti-HER2 treatment before BM was associated with longer TTBM. Anti-HER2 treatment after BM was associated with a survival benefit, especially when both trastuzumab and lapatinib were utilised.

Survival Analysis of Triple Negative and Her2 Positive Breast Cancer Patients: Single Center Report

“…Özellikle bizim çalışmamızda da görüldüğü gibi akciğer, karaciğer ve beyin metastazı yapmaya eğilim söz konusudur. Her2 pozitif hastalarda bizim hastalarda olduğu gibi ilk olarak beyin metastazının ortaya çık-ması azımsanmayacak sıklıktadır (18). Her2 pozitif tümörlerin daha sık beyin metastazı yapmasının nedeni tam olarak anlaşılamamış olsa da monoklonal antikorların kan-beyin bariyerini geçememesine veya bu anatomik bölgede reseptör blokajını tam olarak gerçekleştirememe-sine bağlı olabildiği düşünülmektedir.…”

Role of targeted therapy in the treatment of HER-2-positive breast cancer brain metastases

“…Эта концепция была подтверждена в ряде исследований [26,27]. Кроме того, несколько клини-ческих исследований показали, что сочетание химио-терапии с трастузумабом повышает выживаемость даже после развития метастазов в ГМ [28,29]. Это пре-имущество, как предполагают, в основном обусловле-но улучшением контроля системного заболевания [30].…”

Targeted therapy in HER2-positive breast cancer

“…The analysis demonstrated that lapatinib plus capecitabine treatment was associated with a lower rate of brain tumor progression, compared with capecitabine alone (65). This finding led to several trials of patients with brain metastases treated with lapatinib, with the results suggesting that lapatinib plays a role in the prevention and management of brain metastases in patients with HER2-positive breast cancer (66)(67)(68).…”