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Breast Cancer Research and Treatment

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09-06-2022 | Metastasis | Epidemiology

Local and systemic therapy in breast cancer patients with central nervous system metastases

Authors: Ninke E. A. Wellerdieck, Peter Wessels, Maartje Los, Gabe S. Sonke, Ellen Tromp, Dieta Brandsma

Published in: Breast Cancer Research and Treatment | Issue 2/2022

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.

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Title: Local and systemic therapy in breast cancer patients with central nervous system metastases
Authors: Ninke E. A. Wellerdieck
Peter Wessels
Maartje Los
Gabe S. Sonke
Ellen Tromp
Dieta Brandsma
Publication date: 09-06-2022
Publisher: Springer US
Keywords: Metastasis
Systemic Therapy
Breast Cancer
CNS Metastasis
Breast Cancer
Radiotherapy
Published in: Breast Cancer Research and Treatment / Issue 2/2022
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-022-06605-4

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