Research ExplorerPublicationsDevelopment of central nervous system metastases as a first ...

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, Vol. 21, No. 1, 10.05.2019, p. 60.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Laakmann, E, Witzel, I, Fasching, PA, Rezai, M, Schem, C, Solbach, C, Tesch, H, Klare, P, Schneeweiss, A, Salat, C, Zahm, D-M, Blohmer, J-U, Ingold-Heppner, B, Huober, J, Hanusch, C, Jackisch, C, Reinisch, M, Untch, M, von Minckwitz, G, Nekljudova, V, Müller, V & Loibl, S 2019, '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', BREAST CANCER RES, vol. 21, no. 1, pp. 60. https://doi.org/10.1186/s13058-019-1144-x

APA

Laakmann, E., Witzel, I., Fasching, P. A., Rezai, M., Schem, C., Solbach, C., Tesch, H., Klare, P., Schneeweiss, A., Salat, C., Zahm, D-M., Blohmer, J-U., Ingold-Heppner, B., Huober, J., Hanusch, C., Jackisch, C., Reinisch, M., Untch, M., von Minckwitz, G., ... Loibl, S. (2019). 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. BREAST CANCER RES, 21(1), 60. https://doi.org/10.1186/s13058-019-1144-x

Vancouver

Laakmann E, Witzel I, Fasching PA, Rezai M, Schem C, Solbach C et al. 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. BREAST CANCER RES. 2019 May 10;21(1):60. https://doi.org/10.1186/s13058-019-1144-x

Bibtex

@article{6b8dd3c5a7604ebd9e8c981fcc77f65b,
title = "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",
abstract = "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.",
keywords = "Antineoplastic Combined Chemotherapy Protocols/adverse effects, Breast Neoplasms/epidemiology, Central Nervous System Neoplasms/epidemiology, Female, Follow-Up Studies, Humans, Incidence, Neoadjuvant Therapy, Neoplasm Grading, Neoplasm Staging",
author = "Elena Laakmann and Isabell Witzel and Fasching, {Peter A} and Mahdi Rezai and Christian Schem and Christine Solbach and Hans Tesch and Peter Klare and Andreas Schneeweiss and Christoph Salat and Dirk-Michael Zahm and Jens-Uwe Blohmer and Barbara Ingold-Heppner and Jens Huober and Claus Hanusch and Christian Jackisch and Mattea Reinisch and Michael Untch and {von Minckwitz}, Gunter and Valentina Nekljudova and Volkmar M{\"u}ller and Sibylle Loibl",
year = "2019",
month = may,
day = "10",
doi = "10.1186/s13058-019-1144-x",
language = "English",
volume = "21",
pages = "60",
journal = "BREAST CANCER RES",
issn = "1465-5411",
publisher = "BioMed Central Ltd.",
number = "1",

}

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 -