Central nervous system relapse in patients with untreated HER2-positive esophageal or gastroesophageal junction adenocarcinoma.

Autor: Yoon HH; Department of Medical Oncology, Mayo Clinic, Rochester, MN., Lewis MA; Department of Medical Oncology, MD Anderson Cancer Center, Houston, TX., Foster NR; Department of Health Sciences Research, Mayo Clinic, Rochester, MN., Sukov WR; Department of Cytogenetics, Mayo Clinic, Rochester, MN., Khan M; Department of Leukemia Department, MD Anderson Cancer Center, Houston, TX., Sattler CA; Department of Cytogenetics, Mayo Clinic, Rochester, MN., Wiktor AE; Mayo Collaborative Services, Mayo Clinic, Rochester, MN., Wu TT; Anatomic Pathology, Mayo Clinic, Rochester, MN., Jenkins RB; Department of Cytogenetics, Mayo Clinic, Rochester, MN., Sinicrope FA; Department of Medical Oncology, Mayo Clinic, Rochester, MN.
Jazyk: angličtina
Zdroj: International journal of cancer [Int J Cancer] 2016 Oct 01; Vol. 139 (7), pp. 1626-31. Date of Electronic Publication: 2016 Jun 10.
DOI: 10.1002/ijc.30200
Abstrakt: Although HER2-positive breast cancers demonstrate a propensity for central nervous system (CNS) metastasis, it is unknown whether other HER2-positive tumors, including adenocarcinomas of the esophagus/gastroesophageal junction (EAC), share this characteristic. Insight into this association may inform the development of HER2-targeted therapies that penetrate the blood-brain barrier. We examined HER2 overexpression and gene amplification in 708 patients with EAC who underwent curative-intent surgery during a time period (1980-1997) when no patient received HER2-targeted therapy. We identified patients whose site of first cancer recurrence was CNS and those who had a CNS relapse at any time. After a median follow-up of 61.2 months, 3.4% (24/708) of patients developed CNS relapse (all involved the brain). Patients with HER2-positive (vs -negative) primary tumors showed a higher 5-year cumulative incidence of CNS relapse as first recurrence (5.8% vs. 1.2%; p = 0.0058) and at any time (8.3% vs. 2.4%; p = 0.0062). In a multivariable model that included covariates previously associated with HER2 or with CNS relapse in breast cancer, HER2 positivity was the only variable that was statistically significantly associated with shorter time to CNS relapse as first recurrence (p = 0.0026) or at any time (hazard ratio 4.3 [95% confidence interval 1.8 to 10.3]; p = 0.001). These are the first data in a non-breast cancer to demonstrate an association between HER2 positivity and higher CNS relapse risk after surgery, and suggest that HER2-positive EACs have a predilection for CNS metastases.
(© 2016 UICC.)
Databáze: MEDLINE
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