scholarly journals 74. EFFICACY OF HER2-TARGETED THERAPY IN HER2-POSITIVE BREAST CANCER BRAIN METASTASES: A NATIONAL ANALYSIS

2020 ◽  
Vol 2 (Supplement_2) ◽  
pp. ii15-ii16
Author(s):  
Alexander Hulsbergen ◽  
Marike Broekman ◽  
Timothy Smith ◽  
Bryan Iorgulescu
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Targeted Therapy ◽  
Brain Metastases ◽  
Cox Regression ◽  
National Study ◽  
Landmark Analysis ◽  
Her2 Breast Cancer ◽  
Breast Cancer Brain Metastases ◽  
National Analysis

Abstract BACKGROUND Breast cancer brain metastases (BCBM) commonly develop in human epidermal growth factor 2-positive (HER2+) breast cancer, but BCBM patients are underrepresented in clinical trials, leading to a lack of knowledge on the efficacy of HER2-targeted therapy in this population. METHODS We analyzed clinical characteristics and outcomes of HER2+ BCBM patients from the National Cancer Database 2010–2016, comprising 70% of newly-diagnosed cancers in the U.S, to assess overall survival (OS) associated with HER2-targeted monoclonal antibody therapy (HER2-mab; i.e. trastuzumab, pertuzumab, and trastuzumab emtansine; encoded as of 2013). Survival was estimated with Kaplan-Meier techniques and compared with landmark analysis and Cox regression. The landmark timepoint was selected at which 75% of HER2-mab patients received HER2-mab, which was within 58 days of diagnosis. RESULTS 1,059 HER2+ BCBM patients were identified, 717 (67.7%) patients were estrogen receptor negative (ER-) and 342 (32.3%) were ER+. Median follow-up was 12.0 months, at the end of which 73.8% of patients were deceased. Median OS was 12.2 and 22.1 months for ER- and ER+ patients, respectively. HER2-mab usage for BCBM patients rose from 53.6% in 2013 to 71.7% in 2016. 420 BCBM patients had complete data for landmark analyses: 70.0% (n=294) received HER2-mab and 30.0% (n=126) did not, in which HER2-mab was associated with significantly improved OS in both ER- (median 22.2 months, 95%CI: 18.2–25.4; vs. 9.5 mos, 95%CI: 6.3–10.7; p=0.0001) and ER+ (median 25.7 months, 95%CI: 21.4-not reached; vs. 19.6 months, 95%CI: 11.1–35.2; p=0.02) patients. In multivariable Cox landmark analysis adjusted for ER status, age at diagnosis, extracranial disease, chemotherapy, radiotherapy, and metastasectomy; HER2-mab demonstrated significantly improved OS (hazard ratio 0.59 vs. no HER2-mab, 95%CI: 0.44–0.77; p<0.001). CONCLUSIONS In this large, national study, HER2-mab was associated with substantially improved overall survival in BCBM patients.

scholarly journals NCOG-09. EFFICACY OF HER2-TARGETED ANTIBODY THERAPY IN HER2-POSITIVE BREAST CANCER BRAIN METASTASES: A NATIONAL ANALYSIS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii131-ii131
Author(s):  
Alexander Hulsbergen ◽  
Marike Broekman ◽  
Timothy Smith ◽  
Ayal A Aizer ◽  
Bryan Iorgulescu
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Brain Metastases ◽  
Antibody Therapy ◽  
National Study ◽  
Trastuzumab Emtansine ◽  
Landmark Analysis ◽  
Her2 Breast Cancer ◽  
Breast Cancer Brain Metastases ◽  
National Analysis

Abstract BACKGROUND Breast cancer brain metastases (BCBM) commonly develop in human epidermal growth factor 2-positive (HER2+) breast cancer, but BCBM patients are underrepresented in clinical trials, leading to a lack of knowledge on the efficacy of HER2-targeted therapy in this population. METHODS We analyzed clinical characteristics and outcomes of HER2+BCBM patients from the National Cancer Database 2010–2016, comprising 70% of newly-diagnosed cancers in the U.S, to assess overall survival (OS) associated with HER2-targeted monoclonal antibody therapy (HER2-mab; i.e. trastuzumab, pertuzumab, and trastuzumab emtansine; encoded as of 2013). Survival was estimated with Kaplan-Meier techniques and compared with landmark analysis and Cox regression. The landmark timepoint was selected at which 75% of HER2-mab patients received HER2-mab, which was within 58 days of diagnosis. RESULTS 1,059 HER2+BCBM patients were identified, 717 (67.7%) patients were estrogen receptor negative (ER-) and 342 (32.3%) were ER+. Median follow-up was 12.0 months, at the end of which 73.8% of patients were deceased. Median OS was 12.2 and 22.1 months for ER- and ER+ patients, respectively. Following FDA approvals of pertuzumab (2012) and ado-trastuzumab emtansine (2013), HER2-mab usage for HER2+BCBM patients rose from 53.6% in 2013 to 71.7% in 2016. 420 BCBM patients had complete data for landmark analyses: 70.0% (n=294) received HER2-mab and 30.0% (n=126) did not, in which HER2-mab was associated with significantly improved OS in both ER- (median 22.2 months, 95%CI: 18.2-25.4; vs. 9.5 mos, 95%CI: 6.3-10.7; p=0.0001) and ER+ (median 25.7 months, 95%CI: 21.4-not reached; vs. 19.6 months, 95%CI: 11.1-35.2; p=0.02) patients. In multivariable Cox landmark analysis adjusted for ER status, age at diagnosis, extracranial disease, chemotherapy, radiotherapy, and metastasectomy; HER2-mab demonstrated significantly improved OS (hazard ratio 0.59 vs. no HER2-mab, 95%CI: 0.44-0.77; p< 0.001). CONCLUSIONS In this large national study, HER2-mab was associated with substantially improved overall survival in HER2+ BCBM patients.

Commission on Cancer CP3R Compliance Rates for Treatment of Patients With Triple Negative and HER2+ Breast Cancer: A National Cancer Database Analysis

2021 ◽  
pp. 000313482110516
Author(s):  
Srivarshini C. Mohan ◽  
Joshua Tseng ◽  
Marissa Srour ◽  
Alice Chung ◽  
Ashley Marumoto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cox Regression ◽  
Quality Care ◽  
Private Insurance ◽  
National Cancer Database ◽  
Database Analysis ◽  
Her2 Breast Cancer ◽  
Academic Hospitals ◽  
Multi Agent

Background Cancer Program Practice Profile Reports (CP3R) metrics were released by the Commission on Cancer to provide standards for high-quality care. One metric is the recommendation of combination chemotherapy or chemo-immunotherapy (CIT) within 120 days of diagnosis for women under 70 with AJCC T1cN0M0 or Stage IB-III HER2+ or hormone receptor negative breast cancer ([Multi-agent chemotherapy] MAC). Our study assesses national concordance rates for MAC and CIT. Methods The National Cancer Database was queried from 2004-2014. Results 122,045 patients met criteria, of whom treatment for 101,800 (83.4%) patients was concordant with MAC and CIT. Treatment concordance increased from 75.7% in 2004 to 89.5% in 2014. For HER2+ patients, use of CIT treatment downtrended with progression of pathological stage, from 70.1% (stage I) to 58.1% (stage III). Mean overall survival of patients whose treatment was concordant with MAC and CIT was longer than that of patients who were non-concordant (146.6 vs 143.8 months, P <.01). On Cox regression, there was a survival benefit for concordant patients who were treated at academic hospitals (HR .89, 95% CI 0.802-.976) and had private insurance (HR .76, 95% CI 0.65-.89). Conclusion Compliance with MAC and CIT has improved over the past decade and is associated with a significant improvement in overall survival.

scholarly journals Are we AKT-ually getting closer to making targeted therapy successful in breast cancer brain metastases?

2019 ◽  
Vol 21 (11) ◽  
pp. 1344-1345
Author(s):  
Nazanin Majd ◽  
Shiao-Pei Weathers ◽  
John de Groot
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Brain Metastases ◽  
Breast Cancer Brain Metastases

scholarly journals Role of targeted therapy in the treatment of HER-2-positive breast cancer brain metastases

2016 ◽  
Vol 12 (1) ◽  
pp. 46-51
Author(s):  
G. A. Dashyan ◽  
V. F. Semiglazov ◽  
P. V. Krivorot’ko ◽  
T. Yu. Semiglazova ◽  
E. E. Topuzov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Brain Metastases ◽  
Her 2 ◽  
Breast Cancer Brain Metastases ◽  
Positive Breast Cancer

scholarly journals Favourable outcome of patients with breast cancer brain metastases treated with dual HER2 blockade of trastuzumab and pertuzumab

2021 ◽  
Vol 13 ◽  
pp. 175883592110090
Author(s):  
Elisabeth Sophie Bergen ◽  
Amelie Binter ◽  
Angelika Martina Starzer ◽  
Gerwin Heller ◽  
Barbara Kiesel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Brain Metastases ◽  
Objective Response ◽  
First Line ◽  
Her2 Positive ◽  
First Line Therapy ◽  
Line Therapy ◽  
Intracranial Disease ◽  
Breast Cancer Brain Metastases

Background: Dual human epidermal growth factor receptor 2 (HER2) blockade with trastuzumab and pertuzumab (TP) is a standard therapy of metastatic and localized HER2-positive breast cancer (BC), but its activity in breast cancer brain metastases (BCBM) is unknown. Methods: Patients with HER2-positive BCBM were identified from the Vienna Brain Metastasis Registry and clinical data including patient characteristics, therapies and overall survival (OS) were obtained. Patients were grouped into ‘TP’, ‘other-HER2-targeted therapy’ and ‘no-HER2-targeted therapy’ according to received first-line systemic therapy after diagnosis of BCBM. Radiological re-assessment of intracranial lesions was performed in patients treated with TP as systemic first-line therapy according to RANO response criteria for brain metastases (BM). Results: A total of 252 HER2-positive BC patients with BM were available for this analysis. Patients treated with TP as systemic first-line therapy after diagnosis of BM had a significantly longer OS compared with treatment with other-HER2-targeted therapy and no-HER2-targeted therapy (44 versus 17 versus 3 months, p < 0.001; log-rank test). Among radiologically re-assessed patients treated with TP as systemic first-line therapy after diagnosis of BM, 5/14 patients (35.7%) had complete intracranial remission (CR), 8/14 patients (57.1%) partial intracranial remission (PR), 1/14 patients (7.1%) stable intracranial disease (SD) and 0/14 patients (0.0%) progressive intracranial disease (PD) as best response resulting in an intracranial objective response rate (iORR) of 92.9% and an intracranial clinical benefit rate (iCBR) of 100.0%. Conclusion: First-line therapy with dual HER2-inhibition of TP after BM diagnosis was associated with the longest median OS times in patients with BCBM.

H-Ferritin nanoparticle-mediated delivery of antibodies across a BBB in vitro model for treatment of brain malignancies

2021 ◽  
Author(s):  
Maria Antonietta Rizzuto ◽  
Roberta Dal Magro ◽  
Linda Barbieri ◽  
Laura Pandolfi ◽  
Anna Sguazzini-Viscontini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastases ◽  
In Vitro Model ◽  
Primary Glioblastoma ◽  
Her2 Breast Cancer ◽  
Vitro Model ◽  
Breast Cancer Brain Metastases ◽  
Barrier Model

H-ferritin nanoconjugates of CTX and TZ are developed as carriers across the BBB to allow immunotherapy of primary glioblastoma and HER2+ breast cancer brain metastases. The reliability of the strategy is demonstrated using a transwell barrier model.

Impact of mastectomy in women with stage IV HER2+ breast cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12515-e12515
Author(s):  
Arslan Babar ◽  
Fahrettin Covut ◽  
Tariq Zuheir Kewan ◽  
Shafia Rahman ◽  
Stephen R. Grobmyer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Cleveland Clinic ◽  
Stage Iv ◽  
Rank Test ◽  
Breast Radiotherapy ◽  
Her2 Breast Cancer ◽  
Stage Iv Breast Cancer

e12515 Background: Women with stage IV HER2+ breast cancer typically have longer overall survival (OS) compared to other breast cancer subsets due to the effectiveness of dual anti HER-2 antibody therapy. The role of mastectomy remains controversial. Methods: We reviewed patients who were diagnosed with stage IV HER2+ breast cancer between 2/2015 and 12/2017 at Cleveland Clinic. Overall survival (OS) was estimated by the Kaplan-Meier method, and compared by the log-rank test. Univariable and multivariable analysis were performed using Cox regression to identify predictors of OS. Results: We identified 47 patients, with a median age of 58 (range: 22 – 87). Twenty-eight (60%) and 14 (30%) patients had ER+ and PR+ disease, respectively. Four patients had brain metastasis at time of stage IV diagnosis. All patients received systemic therapy. 17 (36%) patients underwent mastectomy after diagnosis of stage IV breast cancer,. Of the 30 (64%) patients who did not undergo mastectomy, 24 (80%), 2 (7%), and 4 (13%) were treated with both chemotherapy and HER2-directed therapy, chemotherapy alone, and HER2-directed therapy alone, respectively. Breast radiotherapy was performed on 9 (53%) and 8 (27%) patients in mastectomy and no mastectomy cohorts, respectively. Median follow-up time was 22 months . The two-year OS for mastectomy and no mastectomy cohorts were 94% (95% CI: 83 – 100) and 50% (95% CI: 33 – 76), respectively (p=0.009). On univariable analysis, only mastectomy vs no mastectomy (HR: 0.18, 95% CI: 0.04 – 0.80, p=0.025) predicted OS. On multivariable analysis, mastectomy vs no mastectomy has remained to be statistically significant predictor of OS (HR: 0.08, 95% CI: 0.01 – 0.66, p=0.019), whereas age, chemotherapy, HER2-directed therapy, and breast radiation were not independent predictors of improved OS (p>0.05). Conclusions: In our cohort, mastectomy was an independent predictor of longer OS in women with stage IV HER2+ breast cancer.

scholarly journals PO-0644: Overall survival following stereotactic radiosurgery (SRS) for breast cancer brain metastases

2017 ◽  
Vol 123 ◽  
pp. S336-S337
Author(s):  
H. Patel ◽  
S. All ◽  
A. Keller ◽  
B. Dumas ◽  
C. Sherrill ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Breast Cancer Brain Metastases
Sign in / Sign up

Export Citation Format

Share Document