Overall Survival Increase After Treatment of Brain Metastasis for Her-2 Positive Patients Using Trastuzumab
Year: 2019
Type: conference-abstract
Abstract: Objectives: Breast cancer is a heterogeneous, phenotypically diverse disease composed of several biological subtypes that have distinct behavior. Amplification or overexpression of the human epidermal growth factor receptor 2 (HER2) oncogene is presented in approximately 15% of primary invasive breast cancers. Target anti-HER2 therapies have become important agents in the treatment of metastatic breast cancer and have altered the natural course of HER2-positive breast cancer. The risk of brain metastasis in women with overexpression HER2 is 12% in 10 years and a modality of treatment with brain radiosurgery (SRS) has been responsible for increasing local brain control with low morbidity. Methodology: Patients with diagnosis of breast cancer brain metastasis treated with SRS from 2007 to 2017 were divided into 3 groups: 1) HER2-positive who received treatment with trastuzumab (subgroup-1); 2) HER2-positive who didn't receive treatment with trastuzumab (subgroup-2) and; 3) HER2 negative, including triple negative and luminal (subgroup-3). Statistical analysis was performed using Fisher's test and Kaplan-Meier curve, considering 5 criteria separately: overall survival (OS), progression free survival (PFS) for the central nervous system (CNS) after radiosurgery, brain disease free survival (DFS) after diagnosis and survival after radiosurgery for brain metastasis (OSARS-overal survival after RS). Results: Among the 78 patients with brain metastasis of breast cancer treated with SRS, 37% were HER2-positive. WBRT can be avoided in 66% HER2-positive patients, and in the subgroup-1 can be avoided in 62%. OS in 5 years was 31% (mean: 34 months, 95%CI 26.95-42.49). OS after diagnose CNS metastasis in 5 years was 18% . PFS for the CNS after 1st radiosurgery in 1 year was 67% and 5 years was 9% (mean: 56months, 95%CI 19.48-31.50). The average time patient was alive after CNS metastasis was 56 months for subgroup-1 and 31 months for subgroup-2 and 36 months for subgroup-3. OS in 2 years after treatment of CNS metastasis was 80% for subgroup-1 (OR=0.9, 95%CI 0.19-4.5, p=0.01) when compared with subgroup-2, and OS in 2 years after treatment of CNS metastasis was 68% for subgroup-2 and 65% for subgroup-3.
Source: Mastology
Authors: Centro Brasileiro de Radioterapia, Oncologia e Mastologia, Nathalya A. Yagi, Nilceana M. A. Freitas, Centro Brasileiro de Radioterapia, Oncologia e Mastologia, Thais F. Simionatto, Centro Brasileiro de Radioterapia, Oncologia e Mastologia, Sylvia S. Pires, Centro Brasileiro de Radioterapia, Oncologia e Mastologia, Mattheus H. Vale, Centro Brasileiro de Radioterapia, Oncologia e Mastologia, Jean T. Paiva, Centro Brasileiro de Radioterapia, Oncologia e Mastologia, Edesio Martins, Centro Brasileiro de Radioterapia, Oncologia e Mastologia, Ruffo Freitas- Junior, Centro Brasileiro de Radioterapia, Oncologia e Mastologia
Institution: Hospital Araújo Jorge
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2998975977