Abstract 61P
Background
Clinical implication of BRCA mutation in patients with breast cancer (BC) with central nervous system (CNS) metastasis is unclear.
Methods
Data of 2,883 patients with BC who underwent BRCA1/2 mutation test at Asan Medical Center between 2011 and 2018 were reviewed. Clinical characteristics and outcomes were compared according to the presence of BRCA1/2 mutation in patients with BC with CNS metastasis.
Results
Among 2,883 patients, 82 patients developed CNS metastasis: 29 of 696 (4.2%) in BRCA1/2 mutation carriers and 53 of 2,187 (2.4%) in non-BRCA mutation carriers. Median age at CNS metastasis was 41 yrs (range 27-76). The proportion of BC subtypes was different according to the presence of BRCA1/2 mutation: hormone receptor (HR) (+) and HER2 (-) (41.4% vs. 24.5%, P=0.113) and HER2 (+) regardless of HR (6.9% vs. 32.1%, P=0.013) between BRCA1/2 mutation and non-BRCA mutation carriers, while no difference was observed regarding triple-negative BC (TNBC) (51.7% vs. 43.4%) (P=0.470). Among patients with BRCA1/2 mutation, most of the BRCA1 mutation carriers had TNBC (77.8%), whereas most of BRCA2 mutation carriers had HR+ BC (60%) (P=0.060). Median time to CNS metastasis from metastatic BC was 1.1 yrs (95% confidence interval 0.74-1.41) without difference between BRCA1/2 and non-BRCA mutation carriers. BRCA1 carriers significantly develop CNS metastasis earlier than BRCA2 mutation carriers (0.8 vs. 1.6 yrs, P=0.015). Patterns of CNS metastasis were similar by presence of BRCA1/2 mutation: brain parenchymal metastasis (BM) alone (62.1% vs. 73.6%), leptomeningeal metastasis alone (10.3% vs. 9.4%), and both (27.6% vs. 17%). There were no differences in isolated CNS metastasis, single or multiple BM, and uncontrolled CNS metastasis rates with similar treatment of CNS metastasis. At a median follow-up of 24.5 months, median overall survival from CNS metastasis in BRCA1/2 mutation carriers seemed to be shorter than in non-BRCA mutation carriers (6.0 vs. 8.9 months, P=0.284).
Conclusions
CNS involvement is frequent in BRCA1/2 mutated BC and BC subtypes were different according to the presence of BRCA1/2 mutation in patients with BC with CNS metastasis. BRCA1 carriers developed CNS metastasis earlier and may be associated with poor survival.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
420TiP - UpSwinG: Real-world study of TKI activity in patients with EGFR mutation-positive (EGFRm+) NSCLC with uncommon mutations, and sequencing of afatinib followed by osimertinib
Presenter: Satoru Miura
Session: e-Poster Display Session
443TiP - A multicenter, open-label, randomized phase II study to compare the efficacy and safety of lenvatinib in combination with ifosfamide and etoposide versus ifosfamide and etoposide in children, adolescents, and young adults with relapsed or refractory osteosarcoma (OLIE; ITCC-082)
Presenter: Nathalie Gaspar
Session: e-Poster Display Session
7P - Machine learning intratumoral and axillary lymph node magnetic resonance imaging radiomics for predicting axillary lymph node metastasis in patients with early-stage invasive breast cancer (RBC-01 Study)
Presenter: Yujie Tan
Session: e-Poster Display Session
8P - Knowledge, practice and attitudes of physicians in low- and middle-income countries (LMIC) on fertility and pregnancy-related issues in young breast cancer patients
Presenter: Shah Zeb Khan
Session: e-Poster Display Session
9P - Survival status of elderly women with HR+ early breast cancer: An analysis of SEER database
Presenter: Wang Hao
Session: e-Poster Display Session
10P - Neoadjuvant immunotherapy plus chemotherapy in early triple-negative breast cancer: A meta-analysis of randomized controlled trials
Presenter: Jessa Gilda Pandy
Session: e-Poster Display Session
11P - Genetically predicted bipolar disorder is causally associated with increased risk of breast cancer: A Mendelian randomization analysis
Presenter: Haoxin Peng
Session: e-Poster Display Session
12P - Stromal tumour-infiltrating lymphocytes in human epidermal growth factor receptor 2-overexpressing breast cancer: Association with negative nodal metastasis
Presenter: Ren Xiaoqiu
Session: e-Poster Display Session
13P - A retrospective observational study on neoadjuvant chemotherapy in older adults based on the Joint Breast Cancer Registry Singapore
Presenter: Johan Chan
Session: e-Poster Display Session