Abstract 2284
Background
Leptomeningeal metastasis (LM) is associated with grave prognosis in breast cancer (BC) and can be treated with ventriculoperitoneal shunt (VPS). Information regarding LM and VPS based on intrinsic subtype is limited; thus, in the present study, the clinical outcomes of BC treated with VPS were investigated.
Methods
The present retrospective study included 70 patients diagnosed with LM and who received VPS. The patients were divided into four groups based on BC subtype: hormone receptor (HR)+HER2-, HR+/HER2+, HR-/HER2+, and triple negative BC (TNBC).
Results
The median age at the time of diagnosis with LM was 49 years (range 30–69 years). Isolated central nervous system (CNS) metastasis was observed in 37.1% (26/70) of patients, and more than half of the patients (47/70, 67.1%) received whole brain radiotherapy (WBRT) before and/or after VPS. The median overall survival (OS) after CNS metastasis was significantly longer in HR-/HER2+ patients (16.2 months, 95% confidence interval, CI 13.7–18.6, p = 0.009), and anti-HER2 treatment was identified as a significant prognostic factor for better OS based on multivariate analysis (hazard ratio, HR 0.15, 95% CI 0.04–0.57, p = 0.005). TNBC was correlated with shorter OS after CNS metastasis (HR 2.82, 95% CI 1.46–5.48, p = 0.002). The median OS after VPS was 2.3 months (95% CI 1.8–2.7) in all patients, and 6-months OS rates after VPS were 0% and 3.9% in HR-HER2+ and in TNBC, respectively.
Conclusions
The clinical outcome of BC patients after CNS metastasis who received VPS was significantly different in real-world clinical setting based on intrinsic subtype. Anti-HER2 treatment should be attempted after CNS metastasis in HER2+ patients. However, the survival of metastatic BC (MBC) after VPS remains poor, especially in HR-/HER2+ and TNBC subgroups. Further investigations are required to improve the prognosis of LM.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Yeon Hee Park.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4317 - Prognostic factors analysis of 343 patients with adenocarcinoma of esophagogastric junction
Presenter: Yixun Lu
Session: Poster Display session 2
Resources:
Abstract
4099 - Effects of preoperative preparation time on efficacy of neoadjuvant chemotherapy (SOX) in patients with advanced gastric cancer
Presenter: Xinxin Wang
Session: Poster Display session 2
Resources:
Abstract
3769 - The prognostic value of higher absolute lymphocyte counts for patients with surgically resected non-advanced gastric cancer
Presenter: Se Jun Park
Session: Poster Display session 2
Resources:
Abstract
1718 - Trastuzumab and pertuzumab added to neoadjuvant chemoradiotherapy in resectable HER2+ esophageal adenocarcinoma patients: an update on survival and predictive biomarkers in the TRAP study
Presenter: Charlotte Stroes
Session: Poster Display session 2
Resources:
Abstract
5403 - Interim analysis of a phase II trial of perioperative chemotherapy plus avelumab in esophagogastric and gastric adenocarcinoma
Presenter: Thierry Alcindor
Session: Poster Display session 2
Resources:
Abstract
591 - Evaluation of the introduction of primary G-CSF prophylaxis to the FLOT chemotherapy regimen.
Presenter: Kelly-Marie Crampton
Session: Poster Display session 2
Resources:
Abstract
1402 - Subgroup analyses of a randomized two-by-two factorial phase II trial comparing neoadjuvant chemotherapy with 2 and 4 courses of cisplatin/S-1 (CS) and docetaxel/cisplatin/S-1 (DCS) as neoadjuvant chemotherapy for locally advanced gastric cancer
Presenter: Tsutomu Hayashi
Session: Poster Display session 2
Resources:
Abstract
3743 - HER2 Copy Number as Predictor of Disease-Free Survival in HER2-Positive Resectable Gastric Cancer
Presenter: Zimin Liu
Session: Poster Display session 2
Resources:
Abstract
2032 - Effect of neoadjuvant chemotherapy on the Programmed Death-1 pathway in esophageal and gastric cancer
Presenter: Maria Svensson
Session: Poster Display session 2
Resources:
Abstract
4304 - A user-friendly nomogram to predict relapse-free survival (RFS) in western patients with resected gastric cancer (GC)
Presenter: Massimiliano Salati
Session: Poster Display session 2
Resources:
Abstract