Local and systemic therapy in breast cancer patients with central nervous system metastases.
Breast Cancer Res Treat
; 194(2): 365-384, 2022 Jul.
Article
in En
| MEDLINE
| ID: mdl-35680734
ABSTRACT
PURPOSE:
As survival of patients with central nervous system (CNS) metastases from breast cancer is poor and incidence rates are increasing, there is a growing need for better treatment strategies. In the current study, the efficacy of local and systemic therapies was analyzed in breast cancer patients with CNS metastases.METHODS:
Medical records from breast cancer patients with brain and/or leptomeningeal metastases (LM) treated at a tertiary referral center and a teaching hospital between 2010 and 2020 were retrospectively studied. Main outcomes of interest were overall survival (OS) and CNS progression free survival. Analyses were performed among patients with brain metastases (BM) and patients with LM, for the different systemic and local therapies for CNS metastases, and for subgroups based on breast cancer subtypes.RESULTS:
We identified 155 patients, 97 with BM and 58 with LM. Median OS was 15.9 months for patients with BM and 1.5 months for patients with LM. Median OS was significantly longer for HER2-positive patients with BM (22.8 months) vs triple negative (8.4 months) and hormone receptor positive/HER2-negative (5.9 months) (P < 0.001). Patients with BM receiving both local and systemic therapy also had a longer median OS (21.8 months), compared to the other three subgroups (local therapy only 9.9 months, systemic therapy only 4.3 months, no therapy 0.5 months, P < 0.001). No significant difference in OS was observed between different systemic treatment regimens.CONCLUSION:
Breast cancer patients with BM show longest median OS when the subtype is HER2-positive and when they are treated with both local and systemic therapy.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Brain Neoplasms
/
Breast Neoplasms
/
Neoplasms, Second Primary
/
Central Nervous System Neoplasms
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
Language:
En
Journal:
Breast Cancer Res Treat
Year:
2022
Document type:
Article
Affiliation country:
Netherlands