365P - ER, PR & HER2 expression and survival of breast cancer patients with brain metastases (BrM) treated with whole brain radiotherapy (WBRT) +/- system...

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Biomarkers
Breast Cancer, Metastatic
Surgery and/or Radiotherapy of Cancer
Presenter Maung Maung Myat Moe
Citation Annals of Oncology (2014) 25 (suppl_4): iv116-iv136. 10.1093/annonc/mdu329
Authors M.M.M. Moe1, S. Durrani2, G. Bertelli1, D. Pudney1, M. Rolles1, C. Askill1, J. Wagstaff1, V. Vigneswaran1, K. Rowley1, K. Parker1, O. Hatcher1, M. Phan1, S. Gwynne1, R. Banner1, D. Thayabaran3, A. Saiyed3, R. Taylor1
  • 1Oncology, Singleton Hospital, SA2 8QA - Swansea/GB
  • 2Oncology, Bronglais Hospital, Aberyswyth/GB
  • 3Breast Unit, Prince Phillip Hospital, Llanelli/GB

Abstract

Aim

To evaluate the impact of ER, PR and HER2 expression on survival of breast cancer patients who developed symptomatic BrM treated with WBRT with or without systemic therapy.

Methods

Case notes of patients who had WBRT for BrM from breast cancer in Singleton hospital were identified and reviewed for age, recurrence, death, histology, treatments and site of metastatic disease. 1st recurrene was defined as the first local or distant relapse. Patients were molecularly subtyped according to ER, PR &, HER2 expression as follows: Luminal HER2 Negative (LHN) = ER or PR +, Her2 -; Luminal HER2 positive (LHP) = ER or PR + , HER2 +; Non-luminal HER2 positive (H) = ER & PR -, HER2 +; Triple Negative (TN) = ER & PR & HER2 -. SPSS v.16 was used.

Ca Breast - 1st recurrence Ca Breast - BrM Ca Breast - Death 1st recurrence - BrM 1st recurrence - Death BrM - Death
All 26.9 38.2 45.5 7.9 18.1 3.9
LHN 37.7 41.9 50.7 7.2 19.7 3.7
LHP 11.4 39.9 52.4 6.9 26.9 6
H 23.2 31.3 45.5 8.5 24.4 13.5
TN 18.8 31.4 34.2 8.1 13 2
p 0.018 0.017 0.003 0.202 0.001 <0.001

Results

A total of 175 patients were identified for the period between 20.01.05 and 03.12.13. Six (skull mets only) and 14 patients (not enough data or concurrent 2nd primary) were excluded leaving 155 patients eligible for the study. Median age = 59 (range 30 - 85); IDC = 90.3%; grade 2 = 36.8%, Grade 3 = 54.2%; T1 = 27.7%, T2 = 38.7%, T3 = 7%; N0 = 26.4%, N1 = 24.5%, N2 = 18.7%, N3 = 12.3%; ER + =56.1%; PR + =14.2%; HER2 + =31.6%. 6.5% of HER2+ patients received adjuvant anti-HER2 therapy. 83.7% of HER2+ patients received continuous anti-HER2 therapy from metastasis to death. Molecular subtypes were LHN = 44.5%; LHP = 14.2%; H = 17.4%; TN = 23.9%. Median survivals (months) are shown in the table. Only 12 patients were till alive at the time of the analysis.

For LHN, LHP, H & TN, 6 & 12 months survival rates from the onset of BrM are 39.1%; 54.5%; 66.7%; 18.9% (p = 0.001) & 18.8%; 36.4%; 44.4%; 5.4% (p = 0.001), respectively. In multivariate analysis, only nodal stage (6 mo) and molecular subtypes (6 & 12 mo) are statistically significant predictors.

Conclusions

HER2+ patients have better survival than HER2- patients from the onset of BrM, probably due to continuous anti HER2 therapy. The best survival was seen in ER & PR negative, HER2 positive patients. TN patients have dismal prognosis.

Disclosure

All authors have declared no conflicts of interest.