Development of central nervous system metastases as a first site of metastatic disease in breast cancer patients treated in the neoadjuvant trials GeparQuinto and GeparSixto
Standard
Development of central nervous system metastases as a first site of metastatic disease in breast cancer patients treated in the neoadjuvant trials GeparQuinto and GeparSixto. / Laakmann, Elena; Witzel, Isabell; Fasching, Peter A; Rezai, Mahdi; Schem, Christian; Solbach, Christine; Tesch, Hans; Klare, Peter; Schneeweiss, Andreas; Salat, Christoph; Zahm, Dirk-Michael; Blohmer, Jens-Uwe; Ingold-Heppner, Barbara; Huober, Jens; Hanusch, Claus; Jackisch, Christian; Reinisch, Mattea; Untch, Michael; von Minckwitz, Gunter; Nekljudova, Valentina; Müller, Volkmar; Loibl, Sibylle.
in: BREAST CANCER RES, Jahrgang 21, Nr. 1, 10.05.2019, S. 60.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Development of central nervous system metastases as a first site of metastatic disease in breast cancer patients treated in the neoadjuvant trials GeparQuinto and GeparSixto
AU - Laakmann, Elena
AU - Witzel, Isabell
AU - Fasching, Peter A
AU - Rezai, Mahdi
AU - Schem, Christian
AU - Solbach, Christine
AU - Tesch, Hans
AU - Klare, Peter
AU - Schneeweiss, Andreas
AU - Salat, Christoph
AU - Zahm, Dirk-Michael
AU - Blohmer, Jens-Uwe
AU - Ingold-Heppner, Barbara
AU - Huober, Jens
AU - Hanusch, Claus
AU - Jackisch, Christian
AU - Reinisch, Mattea
AU - Untch, Michael
AU - von Minckwitz, Gunter
AU - Nekljudova, Valentina
AU - Müller, Volkmar
AU - Loibl, Sibylle
PY - 2019/5/10
Y1 - 2019/5/10
N2 - BACKGROUND: The incidence of central nervous system (CNS) metastases in breast cancer patients is rising and has become a major clinical challenge. Only few data are published concerning risk factors for the development of CNS metastases as a first site of metastatic disease in breast cancer patients. Moreover, the incidence of CNS metastases after modern neoadjuvant treatment is not clear.METHODS: We analyzed clinical factors associated with the occurrence of CNS metastases as the first site of metastatic disease in breast cancer patients after neoadjuvant treatment in the trials GeparQuinto and GeparSixto (n = 3160) where patients received targeted treatment in addition to taxane and anthracycline-based chemotherapy.RESULTS: After a median follow-up of 61 months, 108 (3%) of a total of 3160 patients developed CNS metastases as the first site of recurrence and 411 (13%) patients had metastatic disease outside the CNS. Thirty-six patients (1%) developed both CNS metastases and other distant metastases as the first site of metastatic disease. Regarding subtypes of the primary tumor, 1% of luminal A-like (11/954), 2% of luminal B-like (7/381), 4% of HER2-positive (34/809), and 6% of triple-negative patients (56/1008) developed CNS metastases as the first site of metastatic disease. In multivariate analysis, risk factors for the development of CNS metastases were larger tumor size (cT3-4; HR 1.63, 95% CI 1.08-2.46, p = 0.021), node-positive disease (HR 2.57, 95% CI 1.64-4.04, p < 0.001), no pCR after neoadjuvant chemotherapy (HR 2.29, 95% CI 1.32-3.97, p = 0.003), and HER2-positive (HR 3.80, 95% CI 1.89-7.64, p < 0.001) or triple-negative subtype (HR 6.38, 95% CI 3.28-12.44, p < 0.001).CONCLUSIONS: Especially patients with HER2-positive and triple-negative tumors are at risk of developing CNS metastases despite effective systemic treatment. A better understanding of the underlying mechanisms is required in order to develop potential preventive strategies.
AB - BACKGROUND: The incidence of central nervous system (CNS) metastases in breast cancer patients is rising and has become a major clinical challenge. Only few data are published concerning risk factors for the development of CNS metastases as a first site of metastatic disease in breast cancer patients. Moreover, the incidence of CNS metastases after modern neoadjuvant treatment is not clear.METHODS: We analyzed clinical factors associated with the occurrence of CNS metastases as the first site of metastatic disease in breast cancer patients after neoadjuvant treatment in the trials GeparQuinto and GeparSixto (n = 3160) where patients received targeted treatment in addition to taxane and anthracycline-based chemotherapy.RESULTS: After a median follow-up of 61 months, 108 (3%) of a total of 3160 patients developed CNS metastases as the first site of recurrence and 411 (13%) patients had metastatic disease outside the CNS. Thirty-six patients (1%) developed both CNS metastases and other distant metastases as the first site of metastatic disease. Regarding subtypes of the primary tumor, 1% of luminal A-like (11/954), 2% of luminal B-like (7/381), 4% of HER2-positive (34/809), and 6% of triple-negative patients (56/1008) developed CNS metastases as the first site of metastatic disease. In multivariate analysis, risk factors for the development of CNS metastases were larger tumor size (cT3-4; HR 1.63, 95% CI 1.08-2.46, p = 0.021), node-positive disease (HR 2.57, 95% CI 1.64-4.04, p < 0.001), no pCR after neoadjuvant chemotherapy (HR 2.29, 95% CI 1.32-3.97, p = 0.003), and HER2-positive (HR 3.80, 95% CI 1.89-7.64, p < 0.001) or triple-negative subtype (HR 6.38, 95% CI 3.28-12.44, p < 0.001).CONCLUSIONS: Especially patients with HER2-positive and triple-negative tumors are at risk of developing CNS metastases despite effective systemic treatment. A better understanding of the underlying mechanisms is required in order to develop potential preventive strategies.
KW - Antineoplastic Combined Chemotherapy Protocols/adverse effects
KW - Breast Neoplasms/epidemiology
KW - Central Nervous System Neoplasms/epidemiology
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Incidence
KW - Neoadjuvant Therapy
KW - Neoplasm Grading
KW - Neoplasm Staging
U2 - 10.1186/s13058-019-1144-x
DO - 10.1186/s13058-019-1144-x
M3 - SCORING: Journal article
C2 - 31077239
VL - 21
SP - 60
JO - BREAST CANCER RES
JF - BREAST CANCER RES
SN - 1465-5411
IS - 1
ER -