Central nervous system metastases in HER-2-positive metastatic breast cancer patients treated with trastuzumab: Incidence, survival, and risk factors

Stefania Gori, Simonetta Rimondini, Verena De Angelis, Mariantonietta Colozza, Giancarlo Bisagni, Gabriella Moretti, Angelo Sidoni, Carlo Basurto, Cynthia Aristei, Paola Anastasi, Lucio Crinò

Research output: Contribution to journalArticle

Abstract

Background. A higher incidence of central nervous system (CNS) metastases in HER-2-positive metastatic breast cancer (MBC) has recently been reported. Materials and Methods. Aims of this observational study were to evaluate the incidence of CNS metastases in HER-2-positive MBC patients, to define the outcome of patients with CNS metastases, and to identify the risk factors for CNS relapse. Results. Between April 1999 and June 2005 we treated 122 consecutive HER-2-positive MBC patients with chemotherapy and trastuzumab. At a median follow-up of 28 months from the occurrence of metastatic disease, 43 patients (35.2%) developed CNS metastases. The median time to death from the diagnosis of CNS metastases was 23.46 months. At multivariate analysis we found that only premenopausal status at diagnosis of breast cancer and visceral metastases as the dominant site at relapse were significantly associated with a higher risk for CNS metastases. Conclusion. The CNS metastasis incidence is very high in HER-2-positive MBC, but the survival after CNS relapse in these patients is longer than in patients unselected for HER-2 status, because of the better control of extracranial disease obtained by trastuzumab. The identified risk factors for CNS relapse could allow us to select a subgroup of HER-2-positive MBC patients as candidates for active surveillance for CNS progression (by computed tomography or magnetic resonance imaging) and/or as candidates for accrual in trials of prevention of CNS relapse.

Original languageEnglish
Pages (from-to)766-773
Number of pages8
JournalThe oncologist
Volume12
Issue number7
DOIs
Publication statusPublished - Jul 2007

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Central Nervous System
Breast Neoplasms
Neoplasm Metastasis
Survival
Incidence
Recurrence
Trastuzumab
Observational Studies
Multivariate Analysis
Tomography
Magnetic Resonance Imaging
Drug Therapy

Keywords

  • CNS metastasis incidence
  • HER-2-positive breast cancer
  • Prognosis
  • Risk factors

ASJC Scopus subject areas

  • Cancer Research
  • Hematology

Cite this

Central nervous system metastases in HER-2-positive metastatic breast cancer patients treated with trastuzumab : Incidence, survival, and risk factors. / Gori, Stefania; Rimondini, Simonetta; De Angelis, Verena; Colozza, Mariantonietta; Bisagni, Giancarlo; Moretti, Gabriella; Sidoni, Angelo; Basurto, Carlo; Aristei, Cynthia; Anastasi, Paola; Crinò, Lucio.

In: The oncologist, Vol. 12, No. 7, 07.2007, p. 766-773.

Research output: Contribution to journalArticle

Gori, S, Rimondini, S, De Angelis, V, Colozza, M, Bisagni, G, Moretti, G, Sidoni, A, Basurto, C, Aristei, C, Anastasi, P & Crinò, L 2007, 'Central nervous system metastases in HER-2-positive metastatic breast cancer patients treated with trastuzumab: Incidence, survival, and risk factors', The oncologist, vol. 12, no. 7, pp. 766-773. https://doi.org/10.1634/theoncologist.12-7-766
Gori, Stefania ; Rimondini, Simonetta ; De Angelis, Verena ; Colozza, Mariantonietta ; Bisagni, Giancarlo ; Moretti, Gabriella ; Sidoni, Angelo ; Basurto, Carlo ; Aristei, Cynthia ; Anastasi, Paola ; Crinò, Lucio. / Central nervous system metastases in HER-2-positive metastatic breast cancer patients treated with trastuzumab : Incidence, survival, and risk factors. In: The oncologist. 2007 ; Vol. 12, No. 7. pp. 766-773.
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AU - Gori, Stefania

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AU - De Angelis, Verena

AU - Colozza, Mariantonietta

AU - Bisagni, Giancarlo

AU - Moretti, Gabriella

AU - Sidoni, Angelo

AU - Basurto, Carlo

AU - Aristei, Cynthia

AU - Anastasi, Paola

AU - Crinò, Lucio

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AB - Background. A higher incidence of central nervous system (CNS) metastases in HER-2-positive metastatic breast cancer (MBC) has recently been reported. Materials and Methods. Aims of this observational study were to evaluate the incidence of CNS metastases in HER-2-positive MBC patients, to define the outcome of patients with CNS metastases, and to identify the risk factors for CNS relapse. Results. Between April 1999 and June 2005 we treated 122 consecutive HER-2-positive MBC patients with chemotherapy and trastuzumab. At a median follow-up of 28 months from the occurrence of metastatic disease, 43 patients (35.2%) developed CNS metastases. The median time to death from the diagnosis of CNS metastases was 23.46 months. At multivariate analysis we found that only premenopausal status at diagnosis of breast cancer and visceral metastases as the dominant site at relapse were significantly associated with a higher risk for CNS metastases. Conclusion. The CNS metastasis incidence is very high in HER-2-positive MBC, but the survival after CNS relapse in these patients is longer than in patients unselected for HER-2 status, because of the better control of extracranial disease obtained by trastuzumab. The identified risk factors for CNS relapse could allow us to select a subgroup of HER-2-positive MBC patients as candidates for active surveillance for CNS progression (by computed tomography or magnetic resonance imaging) and/or as candidates for accrual in trials of prevention of CNS relapse.

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