Clinical implication of Time To Brain Metastasis (TTBM) according to breast cancer subtypes

Hee Kyung Ahn, Yeon Hee Park, Su Jin Lee, Silvia Park, Chi Hoon Maeng, Won Park, Doo Ho Choi, Seung Jae Hur, Jin Seok Ahn, Young-Hyuck Im, Hee Kyung Ahn, Yeon Hee Park, Su Jin Lee, Silvia Park, Chi Hoon Maeng, Won Park, Doo Ho Choi, Seung Jae Hur, Jin Seok Ahn, Young-Hyuck Im

Abstract

The aims of the present study were to investigate how breast cancer (BC) subtypes and treatment affect time to brain metastasis (TTBM). We retrospectively investigated 189 consecutive patients who were diagnosed with brain metastasis (BM) from BC between 2000 and 2009 at Samsung Medical Center. We analyzed TTBM from initial diagnosis of metastatic BC according to subtypes and trastzumab (T) administration before BM diagnosis. The median age of 189 BM patients from BC was 48 years. We divided TTBM into four groups considering BC subtypes and treatment; HR-positive/HER2-negative (n=45), HER2-positive with T before BM development (n=47), HER2-positive without T before BM development (n=39), and TNBC (n=58). The median TTBMs for each group were 17.5 months, 13.7 months, 5.8 months, and 2.9 months, respectively (p<0.001). HER2-positive without T (HR 1.892, p=0.008) and TNBC (HR 1.652, p=0.023) were independently associated with shorter TTBM. In multivariate analysis, HER2-positive without T (hazard ratio 1.725, p=0.002) and TNBC (hazard ratio 1.579, p=0.022) were independent risk factors for worse metastatic OS compared with HR-positive/HER2-negative subtype. TTBMs were shorter in patients with HER2-positive without T and TNBC among BC subtypes. Prospective clinical study for high risk patients for early BM is warranted.

Keywords: Brain metastases; Breast cancer; HER2; Trastuzumab; Triple negative.

Figures

Figure 1
Figure 1
Patients’ cohort.
Figure 2
Figure 2
Time to brain metastases (TTBM) according to breast cancer subtype. (A)Time to brain metastases from diagnosis of primary breast cancer according to subtype and trastuzumab administration before brain metastases development. (B)Time to brain metastases from initial diagnosis of metastatic breast cancer according to subtype and trastuzumab administration before brain metastases development.
Figure 3
Figure 3
Overall survival from the initial diagnosis of distant metastases according to breast cancer subtype.

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Source: PubMed

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