Brain metastases free survival differs between breast cancer subtypes

作者：Berghoff A; Bago Horvath Z; De Vries C; Dubsky P; Pluschnig U; Rudas M; Rottenfusser A; Knauer M; Eiter H; Fitzal F; Dieckmann K; Mader R M; Gnant M; Zielinski C C; Steger G G; Preusser M; Bartsch R^*

来源：British Journal of Cancer, 2012, 106(3): 440-446.

DOI：10.1038/bjc.2011.597

• advanced breast cancer
• brain metastases
• carcinomatous meningitis
• human epidermal growth factor receptor 2 (HER-2)-positive breast cancer
• triple-negative disease

BACKGROUND: Brain metastases (BM) are frequently diagnosed in patients with HER-2-positive metastatic breast cancer; in addition, an increasing incidence was reported for triple-negative tumours. We aimed to compare brain metastases free survival (BMFS) of breast cancer subtypes in patients treated between 1996 until 2010. %26lt;br%26gt;METHODS: Brain metastases free survival was measured as the interval from diagnosis of extracranial breast cancer metastases until diagnosis of BM. HER-2 status was analysed by immunohistochemistry and reanalysed by fluorescent in situ hybridisation if a score of 2+ was gained. Oestrogen-receptor (ER) and progesterone-receptor (PgR) status was analysed by immunohistochemistry. Brain metastases free survival curves were estimated with the Kaplan-Meier method and compared with the log-rank test. %26lt;br%26gt;RESULTS: Data of 213 patients (46 luminal/124 HER-2/43 triple-negative subtype) with BM from breast cancer were available for the analysis. Brain metastases free survival differed significantly between breast cancer subtypes. Median BMFS in triple-negative tumours was 14 months (95% CI: 11.34-16.66) compared with 18 months (95% CI: 14.46-21.54) in HER-2-positive tumours (P = 0.001) and 34 months (95% CI: 23.71-44.29) in luminal tumours (P = 0.001), respectively. In HER-2-positive patients, co-positivity for ER and HER-2 prolonged BMFS (26 vs 15 m; P = 0.033); in luminal tumours, co-expression of ER and PgR was not significantly associated with BMFS. Brain metastases free survival in patients with lung metastases was significantly shorter (17 vs 21 months; P = 0.014). %26lt;br%26gt;CONCLUSION: Brain metastases free survival in triple-negative breast cancer, as well as in HER-2-positive/ER-negative, is significantly shorter compared with HER-2/ER co-positive or luminal tumours, mirroring the aggressiveness of these breast cancer subtypes. British Journal of Cancer (2012) 106, 440-446. doi: 10.1038/bjc.2011.597 www.bjcancer.

• 出版日期2012-1-31