Brain metastases from breast cancer: prognostic significance of HER-2 overexpression, effect of trastuzumab and cause of death

BMC Cancer

Emmanuelle Mouret-Fourme³  Alain Labib¹  Julie Gachet⁴  Pascal Cherel⁵  Youlia Kirova¹  Maya Gutierrez⁴  Christophe Massard²  Ludivine Jouanneau³  Romuald Le Scodan¹ 

[1]Departments of Radiation Oncology, Institut Curie-Hôpital René Huguenin, Saint Cloud, France

[2]Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France

[3]Medical Statistics, Institut Curie-Hôpital René Huguenin, Saint Cloud, France

[4]Medical Oncology, Institut Curie-Hôpital René Huguenin, Saint Cloud, France

[5]Radiology, Institut Curie-Hôpital René Huguenin, Saint Cloud, France

关键词: whole brain radiation therapy;    trastuzumab;    breast cancer;    brain metastases;   

Others  :  1080740
DOI  :  10.1186/1471-2407-11-395

 received in 2011-02-07, accepted in 2011-09-19,  发布年份 2011

【 摘 要 】

Background

To access the prognostic significance of HER-2 overexpression, the effect of trastuzumab and the cause of death in patients with brain metastases (BM) from breast cancer (BC).

Methods

We analyzed the outcome of 130 patients with BM from BC who received whole-brain radiotherapy (WBRT) (without surgery or radiosurgery) between January 1998 and April 2006. Demographic data, tumor characteristics, and treatments were prospectively recorded. The impact of HER-2 overexpression and trastuzumab-based therapy on overall survival (OS) and the cause of death were evaluated.

Results

The median follow-up for the whole population was 6.25 months (mean: 9.15; range: 0.23-53). The median survival time and 1-year survival rates after BM diagnosis were 7.43 months and 35.8% (95% CI: 28-45.7) respectively. The median survival time for HER-2 negative patients (n = 78), HER-2 positive patients not treated with trastuzumab (n = 20) and HER-2 positive patients treated with trastuzumab (n = 32) were 5.9 months, 5.6 months and 19.53 months, respectively. The 1-year survival rates were 26.1%, 29.2% and 62.6% respectively, (p < 0.004). Among the 18 HER-2 positive patients treated with trastuzumab who died, 11 (61%) apparently succumbed from CNS progression, in the face of stable or responsive non-CNS disease. Trastuzumab-based therapy was associated with a 51% reduction in the risk of death (multiadjusted hazard ratio: 0.49; 95% CI, 0.29-0.83).

Conclusions

In our experience, trastuzumab-based therapy for HER-overexpressing tumors was associated with improved survival in BM BC patients. This subgroup of patients may benefit from innovative approaches, in order to obtain better intra cerebral control.

【 授权许可】

   
2011 Le Scodan et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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