Treatment and outcomes of patients in the Brain Metastases in Breast Cancer Network Registry

Witzel, Isabell; Laakmann, Elena; Weide, Rudolf; Neunhöffer, T.; Park-Simon, TW; Schmidt, Marcus; Fasching, Peter A.; Hesse, Tobias; Polasik, A; Mohrmann, Svjetlana; Würschmidt, Florian; Schem, Christian; Bechtner, Christina; Würstlein, Rachel; Fehm, Tanja; Möbus, V.; Burchardi, Nicole; Loibl, Sibylle; Müller, Volkmar

doi:10.1016/j.ejca.2018.07.004

Cited by 78 publications

(81 citation statements)

References 22 publications

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“…The literature review of Lin et al reports a BM rate of 30–55% in patients with metastatic HER2-positive breast cancer and 25–46% in patients with metastatic triple-negative breast cancer [ 9 ]. A median overall survival (OS) of 7.4 months after diagnosis of BM was observed in our previous analysis of the Brain Metastases in Breast Cancer (BMBC) Registry [ 10 ]. The survival rate of patients with BM has not improved over the last decades.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and Clinical Outcome of Breast Cancer Patients with Asymptomatic Brain Metastases

Laakmann

Witzel

Neunhöffer³

et al. 2020

Cancers

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Background: Brain metastases (BM) have become a major challenge in patients with metastatic breast cancer. Methods: The aim of this analysis was to characterize patients with asymptomatic BM (n = 580) in the overall cohort of 2589 patients with BM from our Brain Metastases in Breast Cancer Network Germany (BMBC) registry. Results: Compared to symptomatic patients, asymptomatic patients were slightly younger at diagnosis (median age: 55.5 vs. 57.0 years, p = 0.01), had a better performance status at diagnosis (Karnofsky index 80–100%: 68.4% vs. 57%, p < 0.001), a lower number of BM (>1 BM: 56% vs. 70%, p = 0.027), and a slightly smaller diameter of BM (median: 1.5 vs. 2.2 cm, p < 0.001). Asymptomatic patients were more likely to have extracranial metastases (86.7% vs. 81.5%, p = 0.003) but were less likely to have leptomeningeal metastasis (6.3% vs. 10.9%, p < 0.001). Asymptomatic patients underwent less intensive BM therapy but had a longer median overall survival (statistically significant for a cohort of HER2-positive patients) compared to symptomatic patients (10.4 vs. 6.9 months, p < 0.001). Conclusions: These analyses show a trend that asymptomatic patients have less severe metastatic brain disease and despite less intensive local BM therapy still have a better outcome (statistically significant for a cohort of HER2-positive patients) than patients who present with symptomatic BM, although a lead time bias of the earlier diagnosis cannot be ruled out. Our analysis is of clinical relevance in the context of potential trials examining the benefit of early detection and treatment of BM.

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Section: Introductionmentioning

confidence: 99%

Characteristics and Clinical Outcome of Breast Cancer Patients with Asymptomatic Brain Metastases

Laakmann

Witzel

Neunhöffer³

et al. 2020

Cancers

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“…3 However, clinical observations have revealed that the prognosis for luminal-like breast cancer differs between patients receiving the same treatment, and the effect of endocrine therapy also differs among patients. 4 Therefore, the current method of categorizing the luminal A and luminal B subtypes according to HER-2 does not meet the need for the refinement of luminal-like breast cancer diagnoses or clinical treatment guidance. It is necessary to further refine the categorization of luminal-like breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Gene expression and DNA methylation analyses suggest that immune process‐related ADCY6 is a prognostic factor of luminal‐like breast cancer

Sang

Hao

et al. 2019

J of Cellular Biochemistry

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Breast cancer is a malignant tumor that seriously threatens women's health, and luminal-like cancer subtypes account for the majority of the cases. The purpose of this study was to investigate the relationships among DNA methylation, gene expression profile, and the tumor-immune microenvironment of luminal-like breast cancer, and to identify the potential key genes that regulate immune cell infiltration in luminal-like breast cancer. The ESTIMATE algorithm was applied to calculate immune scores and stromal scores of patients with breast cancer. Kaplan-Meier curves were generated for survival analysis. The clusterProfile package was used for Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis. The protein-protein interaction (PPI) network was constructed using the STRING database and Cytoscape software. Correlations between ADCY6 expression and immune cell infiltration-related pathways were analyzed by gene set variation analysis. R software was used for the statistical analysis and figure generation. Disease-free survival was higher in the immune score-high group than it was in the immune score-low group, while the stromal score had no correlation with prognosis. There were 515 genes that differed in both gene expression and DNA methylation levels, and these genes were mainly enriched in immune process-related pathways. ADCY6 was enriched in module A of the PPI network. Patients with downregulation and hypermethylation of ADCY6 associated with a better prognosis. ADCY6 expression was negatively correlated with the activation of immune process-related signaling pathways, immune checkpoint receptors, and ligands, except for CLEC4G. DNA methylation was found to be involved in the regulation of the key cellular pathways of luminallike breast cancer immune cell infiltration. Additionally, ADCY6 was identified as a prognostic factor involved in the DNA methylation-regulated immune processes in luminal-like breast cancer. K E Y W O R D S ADCY6, DNA methylation, luminal-like breast cancer, tumor-immune microenvironment

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“…Human epidermal growth factor-2 (HER-2)-positive patients have a significantly better prognosis compared with other subtypes, and triplenegative patients have the worst prognosis. 3,4 The various ways of treating of BM include surgery, radiotherapy (whole-brain radiotherapy and stereotactic radiosurgery), and systemic therapy. Corticosteroids and local treatments, including radiotherapy and neurosurgical resection, remain the cornerstones of therapy for BM.…”

Section: Introductionmentioning

confidence: 99%

<p>Brain metastases from breast cancer may respond to endocrine therapy: report of two cases</p>

Wang

Sun

Liu

et al. 2019

OTT

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Brain metastases from breast cancer have a poor prognosis. There have been few cases reported where patients with breast cancer and brain metastases respond well to endocrine therapy (tamoxifen or letrozole). Here, we report the cases of two breast cancer patients with brain metastases who responded to medroxyprogesterone acetate and fulvestrant, respectively. These cases indicate that endocrine therapy could be very effective in the management of brain metastases from breast carcinoma.

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Treatment and outcomes of patients in the Brain Metastases in Breast Cancer Network Registry

Cited by 78 publications

References 22 publications

Characteristics and Clinical Outcome of Breast Cancer Patients with Asymptomatic Brain Metastases

Characteristics and Clinical Outcome of Breast Cancer Patients with Asymptomatic Brain Metastases

Gene expression and DNA methylation analyses suggest that immune process‐related ADCY6 is a prognostic factor of luminal‐like breast cancer

<p>Brain metastases from breast cancer may respond to endocrine therapy: report of two cases</p>

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