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Breast Cancer Subtype And Intracranial Recurrence Patterns After Brain-directed Radiation For Brain Metastases

D. Cagney, N. Lamba, Sofia Montoya, Puyao C. Li, L. Besse, Allison M Martin, Rachel Brigell, P. Catalano, P. Brown, J. Leone, S. Tanguturi, D. Haas-Kogan, B. Alexander, N. Lin, A. Aizer
Published 2019 · Medicine

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PurposeBrain metastases from breast cancer are frequently managed with brain-directed radiation but the impact of subtype on intracranial recurrence patterns after radiation has not been well-described. We investigated intracranial recurrence patterns of brain metastases from breast cancer after brain-directed radiation to facilitate subtype-specific management paradigms.MethodsWe retrospectively analyzed 349 patients with newly diagnosed brain metastases from breast cancer treated with brain-directed radiation at Brigham and Women’s Hospital/Dana-Farber Cancer Institute between 2000 and 2015. Patients were stratified by subtype: hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2−), HER2+ positive (HER2+), or triple-negative breast cancer (TNBC). A per-metastasis assessment was conducted. Time-to-event analyses were conducted using multivariable Cox regression.ResultsOf the 349 patients, 116 had HR+/HER2− subtype, 164 had HER2+ subtype, and 69 harbored TNBC. Relative to HR+/HER2− subtype, local recurrence was greater in HER2+ metastases (HR 3.20, 95% CI 1.78–5.75, p < 0.001), while patients with TNBC demonstrated higher rates of new brain metastases after initial treatment (HR 3.16, 95% CI 1.99–5.02, p < 0.001) and shorter time to salvage whole brain radiation (WBRT) (HR 3.79, 95% CI 1.36–10.56, p = 0.01) and salvage stereotactic radiation (HR 1.86, 95% CI 1.11–3.10, p = 0.02).ConclusionsWe identified a strong association between breast cancer subtype and intracranial recurrence patterns after brain-directed radiation, particularly local progression for HER2+ and distant progression for TNBC patients. If validated, the poorer local control in HER2+ brain metastases may support evaluation of novel local therapy-based approaches, while the increased distant recurrence in TNBC suggests the need for improved systemic therapy and earlier utilization of WBRT.
This paper references
[Radiation therapy of brain metastases].
Y. Obata (1982)
Long-term survival with metastatic cancer to the brain
W. Hall (2000)
Brain Metastases: The HER2 Paradigm
N. Lin (2007)
Brain metastases in patients with advanced breast cancer.
G. Sanna (2007)
Chemotherapy delivery issues in central nervous system malignancy: a reality check.
L. Muldoon (2007)
G Sanna (2007)
Sites of distant recurrence and clinical outcomes in patients with metastatic triple‐negative breast cancer
N. Lin (2008)
Clinical outcomes after a diagnosis of brain metastases in patients with estrogen- and/or human epidermal growth factor receptor 2-positive versus triple-negative breast cancer.
S. Hines (2008)
Clinical outcomes after a diagnosis of brain metastases in patients with estrogenand/or human epidermal growth factor receptor 2-positive versus triple-negative breast cancer
SL Hines (2008)
Human epidermal growth factor receptor 2-positive breast cancer and central nervous system metastases.
B. Leyland-Jones (2009)
Clinical Outcomes and Breast Cancer Subtypes in Patients with Brain Metastases
H. Kwon (2010)
Radiation therapy for brain metastases in breast cancer patients
H. Aoyama (2011)
Epidemiology of Brain Metastases
L. Nayak (2012)
Extracranial metastatic patterns on occurrence of brain metastases
D. Vuong (2011)
Brain metastases in breast cancer: analysis of the role of HER2 status and treatment in the outcome of 94 patients.
E. Fokas (2012)
Brain Metastases in Breast Cancer: Analysis of the Role of HER2 Status and Treatment in the Outcome of 94 Patients
E. Fokas (2012)
Breast cancer subtype affects patterns of failure of brain metastases after treatment with stereotactic radiosurgery
T. Vern-Gross (2012)
The effect of tumor subtype on the time from primary diagnosis to development of brain metastases and survival in patients with breast cancer
P. Sperduto (2013)
Stereotactic radiosurgery for single brain metastases from non-small cell lung cancer: progression of extracranial disease correlates with distant intracranial failure
M. Kress (2013)
Treatment outcomes and prognostic factors for patients with brain metastases from breast cancer of each subtype: a multicenter retrospective analysis
N. Niikura (2014)
R. Rosenfeld (2014)
Treatment and prognosis of breast cancer patients with brain metastases according to intrinsic subtype.
S. Kuba (2014)
Prognostic factors for survival and radiation necrosis after stereotactic radiosurgery alone or in combination with whole brain radiation therapy for 1–3 cerebral metastases
L. Schüttrumpf (2014)
Local Control of Brain Metastasis: Treatment Outcome of Focal Brain Treatments in Relation to Subtypes
J. U. Chong (2015)
Breast cancer brain metastases: biology and new clinical perspectives
I. Witzel (2016)
Breast cancer subtype as a predictor for outcomes and control in the setting of brain metastases treated with stereotactic radiosurgery
C. Grubb (2016)
Effect of Radiosurgery Alone vs Radiosurgery With Whole Brain Radiation Therapy on Cognitive Function in Patients With 1 to 3 Brain Metastases: A Randomized Clinical Trial.
P. Brown (2016)
Changing molecular profile of brain metastases compared with matched breast primary cancers and impact on clinical outcomes
A. Thomson (2016)
PD Brown (2016)
Advances in systemic therapy for metastatic breast cancer: future perspectives
S. Corona (2017)
11 years' follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive early breast cancer: final analysis of the HERceptin Adjuvant (HERA) trial
D. Cameron (2017)
Intrinsic Subtype Switching and Acquired ERBB2/HER2 Amplifications and Mutations in Breast Cancer Brain Metastases
N. Priedigkeit (2017)
Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTG N107C/CEC·3): a multicentre, randomised, controlled, phase 3 trial.
P. Brown (2017)
Brain Metastases in Newly Diagnosed Breast Cancer: A Population-Based Study
Allison M Martin (2017)
Intrinsic subtype switching and acquired ERBB2/HER2 amplifications Breast Cancer Research and Treatment 1 3 and mutations in breast cancer brain metastases
N Priedigkeit (2017)
Intrinsic subtype switching and acquired ERBB2/HER2 amplifications 179 Breast Cancer Research and Treatment (2019) 176:171–179 1 3 and mutations in breast cancer brain metastases
N Priedigkeit (2017)
Incidence, pattern and prognosis of brain metastases in patients with metastatic triple negative breast cancer
Jia Jin (2018)
Preservation of Neurocognitive Function (NCF) with Conformal Avoidance of the Hippocampus during Whole-Brain Radiotherapy (HA-WBRT) for Brain Metastases: Preliminary Results of Phase III Trial NRG Oncology CC001
V. Gondi (2018)
AGuIX® from bench to bedside—Transfer of an ultrasmall theranostic gadolinium-based nanoparticle to clinical medicine
F. Lux (2018)
Hormone receptors status: a strong determinant of the kinetics of brain metastases occurrence compared with HER2 status in breast cancer
A. Darlix (2018)
Implications of Screening for Brain Metastases in Patients With Breast Cancer and Non–Small Cell Lung Cancer
D. Cagney (2018)
Impact of pemetrexed on intracranial disease control and radiation necrosis in patients with brain metastases from non-small cell lung cancer receiving stereotactic radiation.
D. Cagney (2018)
Internal dose escalation is associated with increased local control for non-small cell lung cancer (NSCLC) brain metastases treated with stereotactic radiosurgery (SRS)
C. Abraham (2017)
Atezolizumab and Nab‐Paclitaxel in Advanced Triple‐Negative Breast Cancer
P. Schmid (2018)
high incidence of central nervous system metastases
NU Lin (2019)

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