Clinical characteristics and prognostic factors in patients with breast cancer and leptomeningeal metastases from a large registry of BMBC
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Leptomeningeal metastases (LM) in patients with breast cancer (BC) are associated with a dismal prognosis. We explored clinical characteristics and prognostic factors in patients with BC and LM in the German Brain Metastases in Breast Cancer Registry. METHODS: All patients with histologically confirmed BC and diagnosis of LM (defined as the presence of tumor cells in the cerebrospinal fluid, or presence of typical clinical symptoms in combination with typical magnetic resonance imaging findings) were included. RESULTS: A total of 3857 patients were included in the analysis (n = 859 (22.3 %) with LM). Among patients with LM a median progression-free survival was 4.2 months (95 % CI 3.6-4.8), and median overall survival was 5.7 months (95 % CI 4.9-6.7). In the multivariate analysis older age ( ≥ 60 vs. <60 years, Hazard ratio (HR): 1.65, 95 %CI: 1.25-2.18), worse performance status (ECOG 2-4 vs. 0-1 HR: 2.15, 95 %CI: 1.63-2.82), hormone receptor positive/HER2-negative (HR+/HER2-) or triple-negative subtype (HR: 1.54 95CI%: 1.07-2.23 and HR: 1.87, 95 %CI: 1.25-2.81), and higher number of BM (2-3 vs. 1, HR: 1.49, 95 %CI: 1.05-2.11 4) were significantly associated with a higher risk of death. Stereotactic radiotherapy (HR 0.49 95 %CI 0.30-0.79) and whole brain irradiation (HR: 0.58, 95 %CI: 0.42-0.80), endocrine therapy in patients with HR + BC (HR: 0.31, 95 %CI: 0.21-0.45) as well as HER2-targeted therapy for patients with HER2+ BC (HR 0.41, 95 %CI: 0.25-0.68) were associated with a significantly longer survival. CONCLUSIONS: Clinicopathological factors associated with survival can help clinicians identify patients who are candidates for treatment (de)escalation in clinical trials.
Source: The Breast
Authors: Elena Laakmann, Marcus Schmidt, Kristina Lübbe, Elisa Agostinetto, Mette van Ramshorst, Thomas Decker, Wolfram Malter, Francesco Schettini, Mario Fontes Sousa, Carsten Denkert, Tanja Neunhöffer, Leonor Matos, Sabine Linn, Marc Thill, Rudolf Weide, Amanda Fitzpatrick, Marta Vaz Batista, Christoph Mundhenke, Tjoung-Won Park-Simon, Fanny Le Du, Kerstin Riecke, Tanja Fehm, Isabel Witzel, Julia Rey, Valentina Nekljudova, Sibylle Loibl, Volkmar Müller
Institutions: University Medical Center Hamburg-Eppendorf, Johannes Gutenberg University Mainz, University Medical Center of the Johannes Gutenberg University Mainz, Diakovere, Université Libre de Bruxelles, Institut Jules Bordet, The Netherlands Cancer Institute, University Hospital Cologne, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitätsklinikum Gießen und Marburg, Helios Dr. Horst Schmidt Kliniken Wiesbaden, Champalimaud Foundation, Agaplesion Markus Hospital, Institut für Versorgungsforschung in der Onkologie, King's College London, University Hospital Schleswig-Holstein, Medizinische Hochschule Hannover, Centre Eugène Marquis, Düsseldorf University Hospital, University of Zurich, University Hospital Zurich, German Breast Group
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,200
Award: G4707770081
OpenAlex ID: W4409002970