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Poster display

3799 - HER2 positive breast cancer with central nervous system metastases: Pathological features and clinical outcome

Date

10 Oct 2016

Session

Poster display

Presenters

Giovanna Masci

Citation

Annals of Oncology (2016) 27 (6): 68-99. 10.1093/annonc/mdw365

Authors

G. Masci1, L. Santarpia2, G. Bottai2, L. Giordano3, M. Zuradelli1, R. Torrisi1, L. Di Tommaso4, A. Sagona5, V. Errico5, W. Gatzemeier5, A. Testori5, P. Navarria6, L. Bello7, C. Tinterri5, M. Scorsetti6, A. Santoro1

Author affiliations

  • 1 Medical Oncology And Hematology, Istituto Clinico Humanitas, 20089 - Rozzano/IT
  • 2 Oncology Experimental Therapeutics Unit, Istituto Clinico Humanitas, 20089 - Rozzano/IT
  • 3 Biostatistic Unit, Istituto Clinico Humanitas, 20089 - Rozzano/IT
  • 4 Pathology, Istituto Clinico Humanitas, 20089 - Rozzano/IT
  • 5 Breast Unit, Istituto Clinico Humanitas, 20089 - Rozzano/IT
  • 6 Radiotherapy Unit, Istituto Clinico Humanitas, 20089 - Rozzano/IT
  • 7 Neurosurgery, Istituto Clinico Humanitas, 20089 - Rozzano/IT
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Resources

Abstract 3799

Background

Since the introduction of trastuzumab-containing therapies, patients with HER2+ breast cancers (BC) are experiencing longer progression-free (PFS) and overall survival (OS). However, the increasing life expectancy is associated with an increased incidence of central nervous system (CNS) metastases. Objective of the study is the identification of potential clinico-pathological features associated with CNS metastases compared to patients who develop extracranial metastases in HER2+ patients.

Methods

We respectively analyzed 232 metastatic HER2+ BC patients (ER + /HER2 + , n = 126; ER-/HER2 + , n = 89). OS was estimated by the Kaplan Meier method and differences between groups were assessed by the log-rank test. The incidence of CNS metastases was considered as a time depend variable. Cox proportional Hazard model was used to estimate Hazard ratio (HR) with 95% confidence intervals (CI). Statistical significance was set at 0.05.

Results

We identified 90 HER2+ patients with CNS and 142 patients with different types of metastases. The patients with CNS metastases were younger at the diagnosis (p = 0.015). There was a trend for an increase of CNS metastases in patients with hormone receptor negativity. The median follow-up for the entire cohort was 64.1 months. The median OS was 38.9 months for the entire cohort, 31.6 for patients with CNS metastases, and 44.7 for patients with other metastases (p = 0.005). Patients who received hormonal therapy/adjuvant chemotherapy had a favorable outcome (p 

Conclusions

HER2+ patients with multiple CNS lesions had a poor prognosis regardless of the pathological features and therapeutic approach. Current targeted-therapies are unlikely to be active against brain metastases and novel biological agents are urgently needed.

Clinical trial identification

Legal entity responsible for the study

Humanitas Clinical and Research Center

Funding

Humanitas Clinical and Research Center

Disclosure

All authors have declared no conflicts of interest.

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