The effect of tumor subtype on the time from primary diagnosis to development of brain metastases and survival in patients with breast cancer

Sperduto, Paul W.; Kased, Norbert; Roberge, David; Chao, Samuel T.; Shanley, Ryan; Luo, Xianghua; Sneed, Penny K.; Suh, John H.; Weil, Robert J.; Jensen, Ashley W.; Brown, Paul D.; Shih, Helen A.; Kirkpatrick, John P.; Gaspar, Laurie E.; Fiveash, John B.; Chiang, Veronica; Knisely, Jonathan; Sperduto, Christina Maria; Lin, Nancy U.; Mehta, Minesh P.

doi:10.1007/s11060-013-1083-9

Cited by 148 publications

(94 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We tested the utility of the BS-GPA for determining prognosis in cases of BM. Early detection of BM, KPS, tumor subtype and age have been reported as important prognostic factors in patients with BM from breast cancer (16)(17)(18)20), and KPS and HER2 status were shown in our study to be prognostic factors. In our patient series, actual median survival times after BM were well reflected by patients' BS-GPA scores, and thus BS-GPA was shown to be effective in predicting prognosis upon a diagnosis of BM from breast cancer.…”

Section: Discussionsupporting

confidence: 60%

Prolonged survival after diagnosis of brain metastasis from breast cancer: contributing factors and treatment implications

Honda¹,

Aruga²,

Yamashita³

et al. 2015

Jpn. J. Clin. Oncol.

View full text Add to dashboard Cite

Objective: The prognosis of breast cancer-derived brain metastasis is poor, but new drugs and recent therapeutic strategies have helped extend survival in patients. Prediction of therapeutic responses and outcomes is not yet possible, however. In a retrospective study, we examined prognostic factors in patients with breast cancer-derived brain metastasis, and we tested the prognostic utility of a breast cancer-specific Graded Prognostic Assessment in these patients. Methods: Sixty-three patients diagnosed with brain metastasis from breast cancer treated surgically and adjuvantly were included. We examined clinical variables per primary tumor subtype: ER+/HER2 − (luminal), HER2+ (human epidermal growth factor receptor type 2-enriched) or ER−/PR−/HER2− (triple negative). We also categorized patients' breast cancer-specific Graded Prognostic Assessment scores and analyzed post-brain metastasis survival time in relation to these categories. Results: The breast cancers comprised the following subtypes: luminal, n = 18; human epidermal growth factor receptor type 2-enriched, n = 27 and triple-negative, n = 18; median survival per subtype was 11, 37 and 3 months, respectively. Survival of human epidermal growth factor receptor type 2-enriched patients was longer, though not significantly (P = 0.188), than that of luminal patients. Survival of triple-negative patients was significantly short (vs. human epidermal growth factor receptor type 2-enriched patients, P < 0.001). Karnofsky performance status, HER2 status and the disease-free interval (from initial treatment to first recurrence) were shown to be significant prognostic factors (Karnofsky performance status < 70: relative risk 2.08, P = 0.028; HER2+: relative risk 2.911, P = 0.004; disease-free interval < 24 months: relative risk 1.933, P = 0.011). Breast cancer-specific Graded Prognostic Assessment scores reflected disease-free intervals and survival times. Conclusions: Our data indicate that breast cancer-specific Graded Prognostic Assessment-based prediction will be helpful in determining appropriate therapeutic strategies for patients with brain metastasis from breast cancer.

show abstract

Section: Discussionsupporting

confidence: 60%

Prolonged survival after diagnosis of brain metastasis from breast cancer: contributing factors and treatment implications

Honda¹,

Aruga²,

Yamashita³

et al. 2015

Jpn. J. Clin. Oncol.

View full text Add to dashboard Cite

show abstract

“…A number of studies have reported a significantly longer survival time for patients with BM in HER2-overexpressing breast cancer (17)(18)(19). In the present analysis, a non-significantly prolonged median survival time of patients with HER2-positive disease was observed.…”

Section: Discussionsupporting

confidence: 41%

Radiotherapy of brain metastases from breast cancer: Treatment results and prognostic factors

Kühnöl

Vordermark

2016

Oncology Letters

View full text Add to dashboard Cite

Abstract. Brain metastases (BM) from breast cancer are associated with high morbidity and a poor prognosis. The aim of this study was to analyse the role of radiotherapy in treatment of BM from breast cancer in the context of modern local therapy modalities, current systemic treatment options and prognostic factors. A retrospective analysis of 86 consecutive female patients treated with radiotherapy for BM from breast cancer between 2000 and 2010 was conducted. Patient and treatment characteristics were registered and survival data calculated. All patients received whole-brain radiotherapy (WBRT) with a median dose of 36 Gy, and 19 patients were treated with an additional boost; this included fractionated schemes (median dose, 18 Gy) and radiosurgery (5 and 17 Gy). The median overall survival time from the start of WBRT was 4.1 months in the present cohort. Patients receiving a boost survived 19.7 months in comparison to 3.1 months for patients treated with WBRT alone (P<0.001). Other factors that improved overall survival, based on a univariate analysis, were dose of WBRT and number of BM. There was no statistical evidence for the influence of the human epidermal growth factor receptor 2 status on survival in the current study. The administration of boost treatment following WBRT was also identified as a significant factor influencing survival on multivariate analysis (P=0.030). In conclusion, radiotherapy affects the survival time of patients with BM from breast cancer. In particular, the implementation of boost treatment following WBRT in selected patients seems to extend survival time. IntroductionThe most common brain tumours are intracranial metastases (1). Over 20% of patients with solid malignant tumours develop brain metastases (BM); patients with small-cell lung cancer (45%), melanomas (45%), non-small-cell lung cancer (30%), breast cancer and renal cancer (20%) have the highest risk for the occurrence of intracranial metastases (2). The incidence of clinically detected BM in patients with metastatic breast cancer is 16-20%, and autopsy studies suggest a prevalence of BM of up to 34% (3-6). A number of risk factors for cerebral metastases in breast cancer patients have been reported in the literature; in addition to young age (<35 years), large primary tumour size (>2 cm)and negative estrogen receptor (ER) status, the overexpression of human epidermal growth factor receptor 2 (HER2) has been demonstrated to be associated with a higher risk of BM (7-10).The management of BM includes radiotherapeutic, surgical and medical options. Consideration of a local treatment modality depends on the number of intracranial metastases and potential local complications resulting from their location and size. Patients with multiple BM typically receive whole-brain radiotherapy (WBRT), whilst neurosurgery or stereotactic radiosurgery (SRS) are possible treatment options for patients with a single BM. The application of intrathecal chemotherapy may be selected as the therapeutic regime in cases with meningeal involvement...

show abstract

“…The time interval from the initial diagnosis of breast cancer to BM diagnosis was likely to be short in luminal B and TN types [10], while the time interval was showed to not be an independent prognosis factor for survival [27]. The relationship between the metastatic time courses and survival after BM diagnosis is still not well understood.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Factors Related to the Prognosis of Metastatic Breast Cancer Patients after Development of Brain Metastasis

et al. 2015

View full text Add to dashboard Cite

Background: The prognosis of breast cancer patients with brain metastasis (BM) is extremely poor, and the survival after development of BM is very short. We aimed to investigate clinicopathological factors related to significant effects on the prognosis after BM development. Patients and Methods: This is a retrospective study of 75 early breast cancer patients who received the standard of care and subsequently developed BM. Results: Breast cancer subtype was one of the significant predictors for prognosis after BM diagnosis. Luminal HER2 patients had the most favorable prognosis after BM diagnosis (p = 0.011). Favorable performance status (PS) at BM diagnosis (p < 0.001) and a single metastatic brain tumor (p = 0.032) were significantly associated with good prognosis after BM diagnosis. Metastatic time courses of the patients was found not to be significantly associated with survival after BM diagnosis. Univariate and multivariate analysis indicated that luminal HER2 cancer, favorable PS at BM diagnosis, and a single metastatic brain tumor were the independent prognostic factors for survival after BM development, making a decisive influence on local or systemic control. Conclusion: Appropriate treatments for tumor subtypes and to improve the general condition of patients would result in improved outcomes for the patients with BM.

show abstract

The effect of tumor subtype on the time from primary diagnosis to development of brain metastases and survival in patients with breast cancer

Cited by 148 publications

References 14 publications

Prolonged survival after diagnosis of brain metastasis from breast cancer: contributing factors and treatment implications

Prolonged survival after diagnosis of brain metastasis from breast cancer: contributing factors and treatment implications

Radiotherapy of brain metastases from breast cancer: Treatment results and prognostic factors

Clinicopathological Factors Related to the Prognosis of Metastatic Breast Cancer Patients after Development of Brain Metastasis

Contact Info

Product

Resources

About