Brain metastases in patients who receive trastuzumab-containing chemotherapy for HER2-overexpressing metastatic breast cancer |
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Authors: | Makiko Ono Masashi Ando Mayu Yunokawa Eriko Nakano Kan Yonemori Koji Matsumoto Tsutomu Kouno Chikako Shimizu Kenji Tamura Noriyuki Katsumata Yasuhiro Fujiwara |
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Institution: | (1) Breast and Medical Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;(2) Medical Oncology Division, Hyogo Cancer Center, Hyogo, Japan |
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Abstract: | Background Recently, a high rate of brain metastases has been reported among patients with human epidermal growth factor receptor (HER2)-overexpressing
metastatic breast cancer who were treated with trastuzumab. The present study examined risk factors for the development of
brain metastasis in patients with HER2-overexpressing breast cancer who were treated with trastuzumab.
Methods We retrospectively reviewed 204 patients with HER-2-overexpressing breast cancer who were treated with a trastuzumab-containing
regimen between 1999 and 2006. Patients with clinical symptoms were diagnosed as having brain metastases when brain magnetic
resonance imaging (MRI) or a computed tomography (CT) scan revealed positive findings for brain metastases. The median follow-up
time of this cohort was 53.6 months.
Results Among the patients who received a trastuzumabcontaining regimen, 74 patients (36.3%) developed brain metastases. The median
survival from the diagnosis of brain metastases was 13.5 months (95% confidence interval CI], 12.2–14.7 months). The median
time interval between the beginning of trastuzumab treatment and the diagnosis of brain metastases was 13.6 months (range,
0.0–45.8 months). Among patients with brain metastases, the median overall survival period was 39 months. A multivariate logistic
regression analysis showed that age (≤50 years), recurrent breast cancer, and liver metastases were significant risk factors
for the development of brain metastases.
Conclusion Patients with HER2-overexpressing breast cancer treated with trastuzumab had a high incidence of brain metastases (36.3%).
Routine screening for brain metastases 1 year after the start of trastuzumab treatment, may be warranted in younger patients
(≤50 years) who had recurrent breast cancer with liver metastases. |
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Keywords: | HER2-overexpressing breast cancer Trastuzumab Brain metastases |
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