Universität zu Köln

Maurer, Christian, Tulpin, Lorraine, Moreau, Michel, Dumitrescu, Cristina, de Azambuja, Evandro ORCID: 0000-0001-9501-4509, Paesmans, Marianne, Nogaret, Jean-Marie, Piccart, Martine J. and Awada, Ahmad (2018). Risk factors for the development of brain metastases in patients with HER2-positive breast cancer. ESMO Open, 3 (6). LONDON: BMJ PUBLISHING GROUP. ISSN 2059-7029

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Abstract

Background Patients with metastatic human epidermal growth factor receptor 2-positive breast cancer (HER2+ BC) frequently experience brain metastases (BM). We aimed to define risk factors for the development of BM in patients with HER2+ BC and to report on their outcome. Methods This is a retrospective analysis of patients diagnosed with HER2+ BC between January 2000 and December 2014 at Institut Jules Bordet, Belgium. Statistical analyses were conducted with SAS V.9.4 using Kaplan-Meier method and Cox regression analyses. Results A total of 483 patients were included of whom 108 (22.4%) developed metastases and 52 (10.8%) BM. Among 96 metastatic patients without BM at diagnosis, 40 (41.7%) developed BM in the course of their disease. In multivariate analysis, risk factors for the development of BM were age <= 40 years (HR 2.10, 95 % CI 1.02 to 4.36), tumour size >2 cm (HR 4.94, 95% CI 1.69 to 14.47), nodal involvement (HR 3.48, 95% CI 1.47 to 8.25), absence or late start (>= 6 months after initial diagnosis) of adjuvant anti-HER2 treatment (HR 3.79, 95% CI 1.52 to 9.43 or HR 2.65, 95% CI 1.03 to 6.82) and the development of lung metastases as first site of relapse (HR 6.97, 95% CI 3.41 to 14.24). Twenty-two patients with HER2+ BC and BM sent to our institute for further treatment were included in the outcome analysis. Asymptomatic patients at the time of BM diagnosis showed a better overall survival than symptomatic patients (HR 0.49, 95% CI 0.25 to 0.94). Conclusion A considerable number of patients with metastatic HER2+ BC will develop BM. Screening of patients with risk factors for BM might lead to early detection and better outcome. However, randomised controlled trials examining the use of MRI as a screening method for BM in patients with metastatic BC are warranted before such an approach can be recommended.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Maurer, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Tulpin, Lorraine UNSPECIFIED UNSPECIFIED UNSPECIFIED Moreau, Michel UNSPECIFIED UNSPECIFIED UNSPECIFIED Dumitrescu, Cristina UNSPECIFIED UNSPECIFIED UNSPECIFIED de Azambuja, Evandro UNSPECIFIED orcid.org/0000-0001-9501-4509 UNSPECIFIED Paesmans, Marianne UNSPECIFIED UNSPECIFIED UNSPECIFIED Nogaret, Jean-Marie UNSPECIFIED UNSPECIFIED UNSPECIFIED Piccart, Martine J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Awada, Ahmad UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-178971
DOI:	10.1136/esmoopen-2018-000440
Journal or Publication Title:	ESMO Open
Volume:	3
Number:	6
Date:	2018
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	2059-7029
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AMERICAN-SOCIETY; CNS METASTASES; DISEASE; RECOMMENDATIONS; TRASTUZUMAB; MANAGEMENT; THERAPY; PROGNOSIS; ONCOGENE; SURVIVAL Multiple languages Oncology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17897