257P - Breast-GPA and type of treatment predictors of survival in brain metastasis patients

Date 10 October 2016
Event ESMO 2016 Congress
Session Poster display
Topics Breast Cancer
Presenter Jenniffer Linares
Citation Annals of Oncology (2016) 27 (6): 68-99. 10.1093/annonc/mdw365
Authors J.L. Linares1, A. Stradella2, S. Pernas1, A. Ortega1, M. Galdeano3, A. Lucas3, M. Macia3, N. Vidal4, I. Morilla1, R. Sabela1, C. Falo1, R. Velasco5, M. Gil-Gil1
  • 1Medical Oncology, Institut Català d'Oncologia Hospital Duran i Reynals, 08908 - Barcelona/ES
  • 2Medical Oncology, Institut Català d'Oncologia Hospital Duran i Reynals, Barcelona/ES
  • 3Radiation Oncology, Institut Català d'Oncologia Hospital Duran i Reynals, 08908 - Barcelona/ES
  • 4Pathology, Bellvitge University Hospital, Barcelona/ES
  • 5Neurology, Bellvitge University Hospital, Barcelona/ES

Abstract

Background

Brain metastases (BM) occur in 15-30% of patients with metastatic breast cancer (MBC). In spite of improvements in the treatment, the development of BM is still being a major limitation of life expectancy and quality of life for many patients (P).

Methods

Ambispective analysis of MBC patients who developed single or multiple BM and were treated in a single cancer comprehensive center. Identification of patients and updates of follow up were performed through Radiation Oncology department registries and Pathology Records. Breast Graded Prognostic Assessment (GPA) was calculated according to Sperduto GPA (2012).

Results

From 2007 to 2014, 133 patients were identified; 30(22.6%) were diagnosed at de novo IV stage. Median age at BM diagnosis 52.3 years (29.7-81); 53 (39.8%) were luminal (LT), 42 (31.6%) HER2 positive (Her2), 31 (23.3%) triple negative (TN) and 7 cases unknown. Median PFS was 28m and median time to BM after cancer diagnosis (TBM) was 41 m (71m in LT, 26m in Her-2 and 20 m in TN (p 3 lesions 8 m (5-11) and according subtypes LT 11 m (4-18),TN 8m (4.5-11.5) and Her2 26m (7-45). Local treatment with SRS and S prolonged BMS (28 vs 8 m p= 0.001) as well as the administration of chemotherapy (29 vs 10 m p = 0.032). Significant prognostic factors by multivariate Cox regression were GPA (HR 0.7 CI 0.55-0.91 p = 0.008) and number of lesions (HR 1.3 CI 1.03-1.79 p = 0.027).

Conclusions

Breast-GPA, number of lesions and type of treatment are the most important prognosis factors for MBC patients with BM. Multidisciplinary treatment should be decided according to these factors.

Clinical trial identification

Legal entity responsible for the study

Jenniffer Linares Aceituno

Funding

Catalan Institute of Oncology

Disclosure

All authors have declared no conflicts of interest.