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Central Nervous System Failure in Korean Breast Cancer Patients with HER2-Enriched Subtype: Korean Radiation Oncology Group 16-15 Multicenter Retrospective Study

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Author(s)
Kyubo KimKyung Hwan ShinJin Ho KimDoo Ho ChoiWon ParkYong Bae KimHyun Ju KimJin Hee KimHyeli ParkSun Young LeeJiyoung KimDo Hoon OhIn Ah Kim
Keimyung Author(s)
Kim, Jin Hee
Department
Dept. of Radiation Oncology (방사선종양학)
Journal Title
Journal of Breast Cancer
Issued Date
2019
Volume
22
Issue
1
Keyword
Breast neoplasmsCentral nervous system neoplasmsERBB2 proteinRadiotherapyTrastuzumab
Abstract
Purpose:
The purpose of this study was to evaluate the risk of central nervous system (CNS) failure in Korean patients with human epidermal growth factor receptor 2 (HER2)-enriched breast cancer treated with surgery followed by postoperative radiotherapy (RT).

Methods:
A total of 749 patients from eight institutions were enrolled in this study. All of them underwent surgery followed by postoperative RT from 2003 to 2011; 246 (32.8%) received neoadjuvant chemotherapy and 649 (81.7%) received adjuvant chemotherapy. Adjuvant trastuzumab was administered to 386 patients (48.6%).

Results:
The median follow-up duration was 84 (range, 8–171) months. The 7-year disease-free and overall survival rates were 79.0% and 84.2%, respectively. On multivariate analysis, mastectomy, nodal involvement, and presence of lymphatic invasion were correlated with poor overall survival (p = 0.004, 0.022, and 0.011, respectively), whereas T stage and lymphatic invasion were associated with disease-free survival (p = 0.018 and 0.005, respectively). Regarding CNS failures, 30 brain metastases, 2 leptomeningeal metastases, and 8 brain and leptomeningeal metastases were noted. The 7-year CNS relapse-free survival rates in patients receiving and not receiving trastuzumab were 91.2% and 96.9%, respectively (p = 0.005). On multivariate analysis, the administration of adjuvant trastuzumab was the only prognostic factor in predicting a higher CNS failure rate (hazard ratio, 2.260; 95% confidence interval, 1.076–4.746; p = 0.031).

Conclusion:
Adjuvant trastuzumab was associated with higher CNS failure rate in Korean patients with HER2-enriched breast cancer. Close monitoring and reasonable approaches such as CNS penetrating HER2 blockades combined with the current standard therapy could contribute to improving intracranial tumor control and quality of life in patients with CNS metastasis from HER2-enriched breast cancer.
Keimyung Author(s)(Kor)
김진희
Publisher
School of Medicine (의과대학)
Citation
Kyubo Kim et al. (2019). Central Nervous System Failure in Korean Breast Cancer Patients with HER2-Enriched Subtype: Korean Radiation Oncology Group 16-15 Multicenter Retrospective Study. Journal of Breast Cancer, 22(1), 120–130. doi: 10.4048/jbc.2019.22.e1
Type
Article
ISSN
2092-9900
Source
https://ejbc.kr/DOIx.php?id=10.4048/jbc.2019.22.e1
DOI
10.4048/jbc.2019.22.e1
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41858
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학)
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