Effect of Breast Cancer Receptor Subtypes and CSF Cytology Status on Survival of Patients With Leptomeningeal Disease.

Autor: Niraula S; Vassar Brothers Medical Center, Nuvance Health, Poughkeepsie, NY., Gouli S; Rochester General Hospital, Rochester, NY., Baran AM; University of Rochester Medical Center, Rochester, NY., O'Regan R; University of Rochester Medical Center, Rochester, NY., Tyburski H; University of Rochester Medical Center, Rochester, NY., Zhang H; University of Rochester Medical Center, Rochester, NY., Hardy S; University of Washington School of Medicine, Fred Hutchinson Cancer Center, Seattle, Washington., Mohile N; University of Rochester Medical Center, Rochester, NY., Anders CK; Duke Cancer Institute, Durham, NC., Dhakal A; University of Rochester Medical Center, Rochester, NY. Electronic address: ajay_dhakal@urmc.rochester.edu.
Jazyk: angličtina
Zdroj: Clinical breast cancer [Clin Breast Cancer] 2024 Oct 05. Date of Electronic Publication: 2024 Oct 05.
DOI: 10.1016/j.clbc.2024.09.019
Abstrakt: Background: It is unclear whether breast cancer (BC) subtypes or CSF cytology results are associated with overall survival (OS) among patients with BC leptomeningeal disease (LMD). This single-institution retrospective study compares OS among BC patients with LMD across various breast cancer subtypes and CSF cytology results.
Methodology: The study enrolled BC patients diagnosed with LMD between 2010 and 2023. Breast cancer subtypes were classified as A. ER+/HER2-, HER2+, or triple-negative BC (TNBC); B. HER2+, HER2-Low, HER2-Zero. CSF cytology subtypes included CSF+, CSF-, or CSF not tested (NT). OS was summarized via Kaplan-Meier analysis and compared using log-rank test. Cox models were used for multivariate analyses.
Results: Out of 69 patients registered, median OS (95% CI) for ER+/HER2- (n = 33), HER2+ (n = 12) and TNBC (n = 24) subtypes were 8.0 (3.02, 24.8), 5.71 (1.61, not estimated) and 3.2 (1.11, 4.95) months (P = .17). In multivariate analysis, TNBC was associated with worse OS versus ER+/HER2- [Hazard Ratio (HR), 95% CI: 2.64, 1.23-5.80, P = .04]. HER2 subtypes (HER2-Zero, n = 21; HER2-Low, n = 32; HER2+, n = 12) showed no significant differences in OS. Median OS (95% CI) for CSF+ (n = 16), CSF- (n = 18), and CSF NT (n = 35) groups were 3.54 (1.61, 12.72), 13.41 (4.95, 61.93) and 3.28 (1.44, 6.92) months (P = .04). Multivariate analysis showed both CSF+ and CSF NT were associated with shorter OS compared to CSF- group [HR (95% CI) 4.50 (1.75, 12.11) for CSF+ vs. CSF-; 2.91 (1.45, 6.26) for CSF NT vs. CSF-; P = .002].
Conclusion: TNBC LMD group was associated with worse OS than ER+/HER2- BC LMD when adjusting for other prognostic factors. CSF- LMD patients had better OS than CSF+ or CSF NT LMD.
Competing Interests: Disclosure Ruth O'Regan receives or has received research funding from Puma Biotechnology and is an advisor for Pfizer. Carey Anders receives or has received research funding from Puma Biotechnology, Lilly, Merck, Seattle Genetics, Nektar, Tesaro, G1-Therapeutics, ZION, Novartis, Pfizer, Astra Zeneca, Elucida, Caris, and Incyclix, honoraria from Genentech, Eisai, IPSEN, Seattle Genetics, Astra Zeneca, Novartis, Immunomedics, Elucida, Athenex, and Roche, and receives royalties from UpToDate and Jones and Bartlett. Ajay Dhakal receives or has received research funding from Celcuity and Puma Biotechnology and honoraria from OncLive/MJH Life Sciences, Gilead Sciences, AstraZeneca, and WebMD/Medscape. All other authors state that they have no conflicts of interest.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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