Long-term survival of breast cancer patients with brain metastases: subanalysis of the BMBC registry
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Long-term survival of breast cancer patients with brain metastases: subanalysis of the BMBC registry. / Riecke, K; Müller, V; Neunhöffer, T; Park-Simon, T-W; Weide, R; Polasik, A; Schmidt, M; Puppe, J; Mundhenke, C; Lübbe, K; Hesse, T; Thill, M; Wuerstlein, R; Denkert, C; Decker, T; Fehm, T; Nekljudova, V; Rey, J; Loibl, S; Laakmann, E; Witzel, I.
In: ESMO OPEN, Vol. 8, No. 3, 06.2023, p. 101213.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Long-term survival of breast cancer patients with brain metastases: subanalysis of the BMBC registry
AU - Riecke, K
AU - Müller, V
AU - Neunhöffer, T
AU - Park-Simon, T-W
AU - Weide, R
AU - Polasik, A
AU - Schmidt, M
AU - Puppe, J
AU - Mundhenke, C
AU - Lübbe, K
AU - Hesse, T
AU - Thill, M
AU - Wuerstlein, R
AU - Denkert, C
AU - Decker, T
AU - Fehm, T
AU - Nekljudova, V
AU - Rey, J
AU - Loibl, S
AU - Laakmann, E
AU - Witzel, I
N1 - Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.
PY - 2023/6
Y1 - 2023/6
N2 - BACKGROUND: Up to 30% of metastatic breast cancer (BC) patients develop brain metastases (BM). Prognosis of patients with BM is poor and long-term survival is rare. Identification of factors associated with long-term survival is important for improving treatment modalities.PATIENTS AND METHODS: A total of 2889 patients of the national registry for BM in BC (BMBC) were available for this analysis. Long-term survival was defined as overall survival (OS) in the upper third of the failure curve resulting in a cut-off of 15 months. A total of 887 patients were categorized as long-term survivors.RESULTS: Long-term survivors compared to other patients were younger at BC and BM diagnosis (median 48 versus 54 years and 53 versus 59 years), more often had HER2-positive tumors (59.1% versus 36.3%), less frequently luminal-like (29.1% versus 35.7%) or triple-negative breast cancer (TNBC) (11.9% versus 28.1%), showed better Eastern Cooperative Oncology Group (ECOG) performance status (PS) at the time of BM diagnosis (ECOG 0-1, 76.9% versus 51.0%), higher pathological complete remission rates after neoadjuvant chemotherapy (21.6% versus 13.7%) and lower number of BM (n = 1, BM 40.9% versus 25.4%; n = 2-3, BM 26.5% versus 26.7%; n ≥4, BM 32.6% versus 47.9%) (P < 0.001). Long-term survivors had leptomeningeal metastases (10.4% versus 17.5%) and extracranial metastases (ECM, 73.6% versus 82.5%) less frequently, and asymptomatic BM more often at the time of BM diagnosis (26.5% versus 20.1%), (P < 0.001). Median OS in long-term survivors was about two times higher than the cut-off of 15 months: 30.9 months [interquartile range (IQR) 30.3] overall, 33.9 months (IQR 37.1) in HER2-positive, 26.9 months (IQR 22.0) in luminal-like and 26.5 months (IQR 18.2) in TNBC patients.CONCLUSIONS: In our analysis, long-term survival of BC patients with BM was associated with better ECOG PS, younger age, HER2-positive subtype, lower number of BM and less extended visceral metastases. Patients with these clinical features might be more eligible for extended local brain and systemic treatment.
AB - BACKGROUND: Up to 30% of metastatic breast cancer (BC) patients develop brain metastases (BM). Prognosis of patients with BM is poor and long-term survival is rare. Identification of factors associated with long-term survival is important for improving treatment modalities.PATIENTS AND METHODS: A total of 2889 patients of the national registry for BM in BC (BMBC) were available for this analysis. Long-term survival was defined as overall survival (OS) in the upper third of the failure curve resulting in a cut-off of 15 months. A total of 887 patients were categorized as long-term survivors.RESULTS: Long-term survivors compared to other patients were younger at BC and BM diagnosis (median 48 versus 54 years and 53 versus 59 years), more often had HER2-positive tumors (59.1% versus 36.3%), less frequently luminal-like (29.1% versus 35.7%) or triple-negative breast cancer (TNBC) (11.9% versus 28.1%), showed better Eastern Cooperative Oncology Group (ECOG) performance status (PS) at the time of BM diagnosis (ECOG 0-1, 76.9% versus 51.0%), higher pathological complete remission rates after neoadjuvant chemotherapy (21.6% versus 13.7%) and lower number of BM (n = 1, BM 40.9% versus 25.4%; n = 2-3, BM 26.5% versus 26.7%; n ≥4, BM 32.6% versus 47.9%) (P < 0.001). Long-term survivors had leptomeningeal metastases (10.4% versus 17.5%) and extracranial metastases (ECM, 73.6% versus 82.5%) less frequently, and asymptomatic BM more often at the time of BM diagnosis (26.5% versus 20.1%), (P < 0.001). Median OS in long-term survivors was about two times higher than the cut-off of 15 months: 30.9 months [interquartile range (IQR) 30.3] overall, 33.9 months (IQR 37.1) in HER2-positive, 26.9 months (IQR 22.0) in luminal-like and 26.5 months (IQR 18.2) in TNBC patients.CONCLUSIONS: In our analysis, long-term survival of BC patients with BM was associated with better ECOG PS, younger age, HER2-positive subtype, lower number of BM and less extended visceral metastases. Patients with these clinical features might be more eligible for extended local brain and systemic treatment.
KW - Humans
KW - Triple Negative Breast Neoplasms
KW - Brain Neoplasms/therapy
KW - Prognosis
KW - Brain
U2 - 10.1016/j.esmoop.2023.101213
DO - 10.1016/j.esmoop.2023.101213
M3 - SCORING: Journal article
C2 - 37075697
VL - 8
SP - 101213
JO - ESMO OPEN
JF - ESMO OPEN
SN - 2059-7029
IS - 3
ER -
