Central nervous system relapse in patients with untreated HER2-positive esophageal or gastroesophageal junction adenocarcinoma
| Autor: | Anne E. Wiktor, Harry H. Yoon, Mark A. Lewis, Robert B. Jenkins, Nathan R. Foster, Christopher A. Sattler, Maliha Khan, William R. Sukov, Tsung Teh Wu, Frank A. Sinicrope |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Oncology Cancer Research medicine.medical_specialty Proportional hazards model business.industry Hazard ratio Cancer Gastroesophageal Junction Adenocarcinoma medicine.disease Gastroenterology Metastasis 03 medical and health sciences 030104 developmental biology 0302 clinical medicine Breast cancer 030220 oncology & carcinogenesis Internal medicine medicine Adenocarcinoma Cumulative incidence skin and connective tissue diseases business |
| Zdroj: | International Journal of Cancer. 139:1626-1631 |
| ISSN: | 0020-7136 |
| DOI: | 10.1002/ijc.30200 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text