The HERBA Study: A Retrospective Multi-Institutional Italian Study on Patients With Brain Metastases From HER2-Positive Breast Cancer

Prognostic factors of brain metastasis and survival among HER2-positive metastatic breast cancer patients: a systematic literature review

“…The most commonly assessed predictive factors for shorter survival after BM diagnosis included age, HR status, number of brain lesions, receipt of anti-HER2 therapy, and receipt of any systemic therapy. Four studies reported no association between age at BM diagnosis and survival [ 15 , 27 , 31 , 35 ], three reported shorter survival among older patients [ 18 , 24 , 33 ], and one reported shorter survival among younger patients [ 28 ]. The nine studies that observed HR status reported no association between HR status and survival after BM diagnosis [ 15 , 24 , 25 , 27 , 28 , 31 – 33 , 36 ].…”

“…Four studies reported no association between age at BM diagnosis and survival [ 15 , 27 , 31 , 35 ], three reported shorter survival among older patients [ 18 , 24 , 33 ], and one reported shorter survival among younger patients [ 28 ]. The nine studies that observed HR status reported no association between HR status and survival after BM diagnosis [ 15 , 24 , 25 , 27 , 28 , 31 – 33 , 36 ]. Six studies reported that the presence of a higher number brain lesions compared with fewer brain lesions was associated with shorter survival after BM diagnosis [ 18 , 24 , 25 , 27 , 28 , 33 ].…”

“…The nine studies that observed HR status reported no association between HR status and survival after BM diagnosis [ 15 , 24 , 25 , 27 , 28 , 31 – 33 , 36 ]. Six studies reported that the presence of a higher number brain lesions compared with fewer brain lesions was associated with shorter survival after BM diagnosis [ 18 , 24 , 25 , 27 , 28 , 33 ]. Other reported predictors of shorter survival after BM diagnosis included the presence of neurologic symptoms [ 24 , 26 , 27 ], tumor grade 3, two or more extracranial metastatic sites [ 33 ], central nervous system disease at BC diagnosis [ 31 ], uncontrolled extracranial metastases [ 27 , 28 ], visceral metastases, and Radiation Therapy Oncology Group recursive partitioning analysis prognostic class 3 versus class 1/2 [ 39 ].…”

“…All 13 studies that assessed treatment with anti-HER2 therapy and survival after BM diagnosis reported an association between anti-HER2 therapy and survival. Twelve studies reported that patients who received anti-HER2 therapy after their BM diagnosis had a longer survival compared with patients who did not receive anti-HER2 therapy [ 17 – 20 , 24 , 25 , 27 , 28 , 30 , 31 , 36 , 39 ]. Four studies [ 18 , 25 , 33 , 36 ] found that patients receiving both trastuzumab and lapatinib after their BM diagnosis had longer survival than those receiving either agent alone or no anti-HER2 therapy.…”

“…Four studies [ 18 , 31 , 35 , 39 ] assessed non-HER2-targeted therapies and survival after BM diagnosis and reported that shorter survival was associated with no chemotherapy versus chemotherapy [ 18 , 31 ], no hormonal therapy versus hormonal therapy [ 18 ], WBRT alone versus any systemic therapy after WBRT [ 39 ], and no systemic therapy versus any systemic therapy [ 35 ]. In addition, three studies reported that patients receiving surgery or stereotactic radiosurgery had longer survival than those not receiving these treatments [ 24 , 31 , 33 ], while one study reported no association [ 35 ]. One study reported no association between the total dose of radiotherapy and survival after BM diagnosis [ 28 ].…”