Prolonged survival after diagnosis of brain metastasis from breast cancer: contributing factors and treatment implications
| Autor: | Dai Kitagawa, Hiromi Miyamoto, Yayoi Honda, Tomoyuki Aruga, Kazumi Horiguchi, Risa Goto, Toshinari Yamashita, Katsumasa Kuroi, Nami Idera |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Oncology CA15-3 Cancer Research medicine.medical_specialty Receptor ErbB-2 Breast Neoplasms Metastasis Breast cancer Risk Factors Internal medicine Biomarkers Tumor medicine Humans Radiology Nuclear Medicine and imaging Karnofsky Performance Status Aged Retrospective Studies Brain Neoplasms business.industry Cancer Retrospective cohort study General Medicine Middle Aged Prognosis medicine.disease Primary tumor Receptors Estrogen Relative risk Female Receptors Progesterone business Brain metastasis |
| Zdroj: | Japanese Journal of Clinical Oncology. 45:713-718 |
| ISSN: | 1465-3621 0368-2811 |
| DOI: | 10.1093/jjco/hyv067 |
| Popis: | OBJECTIVE The prognosis of breast cancer-derived brain metastasis is poor, but new drugs and recent therapeutic strategies have helped extend survival in patients. Prediction of therapeutic responses and outcomes is not yet possible, however. In a retrospective study, we examined prognostic factors in patients with breast cancer-derived brain metastasis, and we tested the prognostic utility of a breast cancer-specific Graded Prognostic Assessment in these patients. METHODS Sixty-three patients diagnosed with brain metastasis from breast cancer treated surgically and adjuvantly were included. We examined clinical variables per primary tumor subtype: ER+/HER2- (luminal), HER2+ (human epidermal growth factor receptor type 2-enriched) or ER-/PR-/HER2- (triple negative). We also categorized patients' breast cancer-specific Graded Prognostic Assessment scores and analyzed post-brain metastasis survival time in relation to these categories. RESULTS The breast cancers comprised the following subtypes: luminal, n = 18; human epidermal growth factor receptor type 2-enriched, n = 27 and triple-negative, n = 18; median survival per subtype was 11, 37 and 3 months, respectively. Survival of human epidermal growth factor receptor type 2-enriched patients was longer, though not significantly (P = 0.188), than that of luminal patients. Survival of triple-negative patients was significantly short (vs. human epidermal growth factor receptor type 2-enriched patients, P < 0.001). Karnofsky performance status, HER2 status and the disease-free interval (from initial treatment to first recurrence) were shown to be significant prognostic factors (Karnofsky performance status < 70: relative risk 2.08, P = 0.028; HER2+: relative risk 2.911, P = 0.004; disease-free interval < 24 months: relative risk 1.933, P = 0.011). Breast cancer-specific Graded Prognostic Assessment scores reflected disease-free intervals and survival times. CONCLUSIONS Our data indicate that breast cancer-specific Graded Prognostic Assessment-based prediction will be helpful in determining appropriate therapeutic strategies for patients with brain metastasis from breast cancer. |
| Databáze: | OpenAIRE |
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