Intensified local treatment and systemic therapy significantly increase survival in patients with brain metastases from advanced breast cancer – A retrospective analysis

Bartsch, Rupert; Fromm, Sabine; Rudas, Margaretha; Wenzel, Catharina; Harbauer, Stefanie; Rössler, Karl; Kitz, K.; Steger, Guenther G.; Weitmann, Hajo-Dirk; Poetter, Richard; Zielinski, Christoph; Dieckmann, Karin

doi:10.1016/j.radonc.2006.08.001

Cited by 35 publications

(20 citation statements)

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“…In our analysis, survival time after BM in HER2-positive patientswasverylowwithamedianof3months.Thismight be due to the fact that trastuzumab treatment beyond progressionwasnostandardduringthestudyperiod.Intensifiedlocalandsystemictreatmenthasshowntoimproveoverall survival rates in breast cancer patients with BM [15]. Survival depends on Karnofsky performance status [28] and treatmentmodality [31].Currently,nofactorsforprediction ofveryshortsurvivalinpatientswithBMexist [32].…”

Section: Discussionmentioning

confidence: 99%

“…MediansurvivalafterthediagnosisofBMisreportedwith conflictingresults,butseemstobelongerforHER2-positive than for HER2-negative tumours [14]. Survival after the diagnosis of BM varies according to prognostic factors [15], and has been described in the range of 3-7 months [16]. Despitetheuseofneurosurgeryorstereotacticradiosurgery inselectedcases,mostpatientslivelessthan1year [17].…”

Section: Introductionmentioning

confidence: 99%

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Management of Patients with Brain Metastases Receiving Trastuzumab Treatment for Metastatic Breast Cancer

et al. 2011

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Background: With the more effective control of visceral metastases in patients with metastatic breast cancer (MBC), an increasing number of patients face brain metastases (BM). The aim of this retrospective analysis was to investigate the incidence and factors affecting the prognosis of patients with BM under trastuzumab treatment for MBC. Patients and Methods: A total of 75 HER2positive patients treated with trastuzumab for MBC were included. Results are discussed in the context of the current literature. Results: Patients who developed BM (n = 29) had longer median progression-free survival (PFS) during first-line chemotherapy and longer overall survival (OS) after diagnosis of MBC than 46 patients without BM (PFS: 27 vs. 14 months, p = 0.039; OS: 46 vs. 18 months, p = 0.067). Median survival of patients with continuation of trastuzumab after diagnosis of BM was longer than survival of patients with discontinuation of trastuzumab treatment after BM (18 vs. 3 months, p = 0.006). Survival of patients who were treated with surgery and radiotherapy for BM was better compared with radiotherapy alone (9 vs. 5 months, p = not significant) or best supportive care (9 vs. 2 months, p = 0.049). Conclusions: Continuation of trastuzumab treatment as well as resection of BM seem to give further benefit in the treatment of patients with HER2-overexpressing MBC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of Patients with Brain Metastases Receiving Trastuzumab Treatment for Metastatic Breast Cancer

et al. 2011

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“…Clinicians should take the time accurately to assess and document their patients' performance status (37). The Karnofsky Performance Status (KPS) has been found to be a significant prognostic factor for survival in patients with brain metastases from breast cancer (38)(39)(40)(41)(42)(43), and most long-term survivors have KPS scores of 70-100 (42,43).…”

Section: Natural Course and Prognostic Factorsmentioning

confidence: 99%

Brain Metastases in Breast Cancer

Niikura

Tokuda

Iwata

2014

Japanese Journal of Clinical Oncology

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Brain metastases are less common than bone or visceral metastases in patients with breast cancer. The overall prognosis of breast cancer patients with brain metastases remains poor, and these metastases are less responsive to systemic therapies. Brain metastasis is associated with a reduced quality of life due to progressive neurologic impairments. Recently, a trend of increased incidence of brain metastases in breast cancer has been noted. Reasons for this increased incidence include the more frequent use of sensitive detection methods such as contrast-enhanced magnetic resonance imaging and increased awareness of brain metastasis among patients and clinicians. Adjuvant and systemic therapy with drugs that have a low blood -brain barrier penetrance can lead to an increased risk of brain metastases in breast cancer patients. Molecular subtype is a predictive factor for overall survival after developing brain metastases. Patients who do not have a poor prognosis based on previously identified prognostic factors should be treated with radiation therapy to control symptoms. Whole-brain radiation therapy, stereotactic irradiation and surgery are tools for the local treatment of brain metastases. Novel molecular target therapy, including HER2-targeted therapy, has demonstrated an antitumor effect on brain metastases. In this review, we provide a practical algorithm for the treatment of breast cancer brain metastases. This review provides an overview of the incidence, risk factors, diagnosis, prognostic factors and current and potential future management strategies of breast cancer brain metastases.

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“…L'indication de la RT cé ré brale en totalité peut surtout ê tre remise en question chez les sujets â gé s et/ou ayant des anté cé dents vasculaires et/ou une maladie neurologique pré existante. Un complé ment localisé par SRS ou par RT conformationnelle classique pourrait aussi ê tre indiqué (dose de 15-20 Gy) [14].…”

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Cancer du sein métastatique

2009

Oncologie

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Intensified local treatment and systemic therapy significantly increase survival in patients with brain metastases from advanced breast cancer – A retrospective analysis

Cited by 35 publications

References 42 publications

Management of Patients with Brain Metastases Receiving Trastuzumab Treatment for Metastatic Breast Cancer

Management of Patients with Brain Metastases Receiving Trastuzumab Treatment for Metastatic Breast Cancer

Brain Metastases in Breast Cancer

Cancer du sein métastatique

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