Clinical outcomes and prognostic factors in HER-2 positive breast cancer with brain metastasis: A single-center experience.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13015-e13015
Author(s):  
Serdar Karakaya ◽  
İbrahim Karadağ ◽  
Ayse Ocak Duran ◽  
Omur Berna Oksuzoglu ◽  
Umut Demirci
Keyword(s):  
Breast Cancer ◽  
Brain Metastasis ◽  
Median Overall Survival ◽  
De Novo ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Multiple Brain Metastasis ◽  
Ecog Ps ◽  
The Brain ◽  
Positive Breast Cancer

e13015 Background: Brain metastasis is common in HER2 positive metastatic breast cancer patients. There is limited data on the prognosis, incidence, treatment, risk factors and complications of brain metastasized breast cancer because most clinical trials excluded these patients. we aimed to determine the characteristics and prognosis of brain metastasized HER2 positive breast cancer in our patient group, retrospectively. Methods: We scanned 3100 patients retrospectively and included 105 patients who met the criteria for inclusion in the study. Patients older 18 years old, had HER2 positive breast cancer and brain metastasis with no secondary malignity participated in the study. Results: In total, 35 (33.3%) patients had de-novo metastasis. Median overall survival (OS) was found to be 50 months in all patients. Median OS was 31 and 66 months for patients with de-novo metastasis (without brain metastasis) and patients with no metastasis at the time of the diagnosis, respectively (p < 0.01). When we compared median OS between 25 patients with one brain metastasis and 80 patients with multiple brain metastasis, it was found to be 90 months in the first-mentioned group whereas it was determined to be 45 in the latter group (p < 0.01). In all patients, the median elapsed time for the occurrence of brain metastasis was 22 months (for de-novo metastasis 15 months, for no metastasis 35 months; p < 0.01). Median OS was determined to be 15 months for all patients with brain metastasis after the occurrence of the metastasis. Patients with ECOG PS score of 0-1 at the time of the brain metastasis had 19 months median OS, while patients with ECOG PS score of 2 at the time of the brain metastasis had 8 months median OS (p < 0.01). Median OS after brain metastasis was 32 and 14 months for patients with one brain metastasis and patients with multiple brain metastasis, respectively (p < 0.01). Multivariate cox regression analyses revealed that elapsed time for the occurrence of brain metastasis was shorter in patients with high-grade tumours compared to patients with low-grade tumours (p = 0.04), and in patients with de-novo metastasis compared to patients without de-novo metastasis (p < 0.01). Conclusions: Our study indicated that tumour grade and de-novo metastasis are independent predictive factors that may cause the earlier occurrence of brain metastasis and affect mortality in breast cancer patients. After the occurrence of brain metastasis, lower ECOG PS score and multiple brain metastasis at the time of the diagnosis affected median overall survival as bad prognostic factors.

scholarly journals Molecular and cellular mechanisms underlying brain metastasis of breast cancer

2020 ◽  
Vol 39 (3) ◽  
pp. 711-720 ◽  
Author(s):  
Mari Hosonaga ◽  
Hideyuki Saya ◽  
Yoshimi Arima
Keyword(s):  
Breast Cancer ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Cancer Cells ◽  
Metastatic Cancer ◽  
Breast Cancer Patients ◽  
Cellular Mechanisms ◽  
Her2 Positive ◽  
Cells Of The Microenvironment ◽  
The Brain

Abstract Metastasis of cancer cells to the brain occurs frequently in patients with certain subtypes of breast cancer. In particular, patients with HER2-positive or triple-negative breast cancer are at high risk for the development of brain metastases. Despite recent advances in the treatment of primary breast tumors, the prognosis of breast cancer patients with brain metastases remains poor. A better understanding of the molecular and cellular mechanisms underlying brain metastasis might be expected to lead to improvements in the overall survival rate for these patients. Recent studies have revealed complex interactions between metastatic cancer cells and their microenvironment in the brain. Such interactions result in the activation of various signaling pathways related to metastasis in both cancer cells and cells of the microenvironment including astrocytes and microglia. In this review, we focus on such interactions and on their role both in the metastatic process and as potential targets for therapeutic intervention.

scholarly journals Proliferative Classification of Intracranially Injected HER2-positive Breast Cancer Cell Lines

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1811
Author(s):  
Yuka Kuroiwa ◽  
Jun Nakayama ◽  
Chihiro Adachi ◽  
Takafumi Inoue ◽  
Shinya Watanabe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastasis ◽  
Cell Lines ◽  
Breast Cancer Cell Lines ◽  
Breast Cancers ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
Positive Breast Cancer Cell ◽  
The Brain ◽  
Positive Breast Cancer

HER2 is overexpressed in 25–30% of breast cancers, and approximately 30% of HER2-positive breast cancers metastasize to the brain. Although the incidence of brain metastasis in HER2-positive breast cancer is high, previous studies have been mainly based on cell lines of the triple-negative subtype, and the molecular mechanisms of brain metastasis in HER2-positive breast cancer are unclear. In the present study, we performed intracranial injection using nine HER2-positive breast cancer cell lines to evaluate their proliferative activity in brain tissue. Our results show that UACC-893 and MDA-MB-453 cells rapidly proliferated in the brain parenchyma, while the other seven cell lines moderately or slowly proliferated. Among these nine cell lines, the proliferative activity in brain tissue was not correlated with either the HER2 level or the HER2 phosphorylation status. To extract signature genes associated with brain colonization, we conducted microarray analysis and found that these two cell lines shared 138 gene expression patterns. Moreover, some of these genes were correlated with poor prognosis in HER2-positive breast cancer patients. Our findings might be helpful for further studying brain metastasis in HER2-positive breast cancer.

scholarly journals Approachment to the Brain Metastasis without Extracranial Metastasis of the HER2 Positive Metastatic Breast Cancer

2020 ◽  
pp. 1-6
Author(s):  
Bala Basak Oven ◽  
Altay Aliyev ◽  
Bala Basak Oven ◽  
Eda Tanrıkulu ◽  
Ilker Nihat Okten ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastasis ◽  
Cancer Patients ◽  
Univariate Analysis ◽  
Local Treatment ◽  
Extracranial Metastasis ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Her 2 ◽  
Positive Breast Cancer

Introduction: Breast cancer is one of the most common malignancy that metastases to brain with the risk of 10-16%. Brain metastasis has been reported to be more common among younger women with tumors larger diameter and higher grade, hormone negative and HER2 positive ones. We reviewed inhere treatment of patients with brain metastasis without extracranial metastasis of HER-2 positive breast cancer. Patients and Method: Totally 470 HER2 positive breast cancer patients were evacuated and treatment and clinicopathological factors of 20 patients with brain progression without extracranial metastasis were revised retrospectively. Overall survival (OS) and progression free survival (PFS)and related factors were analysed with univariate analysis. Results: Median survival could not to be reached but, 3 years survival rate was 77% and median PFS was 16.1 months. Brain metastasis were treated with surgery followed with radiotherapy among 9 patients (45%) and only with radiotherapy other 11 (55%) patients. While nearly half of the patients received trastuzumab based therapy after local treatment, lapatinib-capecitabine were given to 7 (35%) and TDM-1 to 4 (20%) patients. There is no significant relation with anti-HER2 therapy in respect to OS or PFS. Conclusion: Although anti-HER2 therapy has known to be improve prognosis of HER-2 positive breast cancer with brain metastasis, there is no consensus which therapy is better. Treatment option can be based adverse effect, patient performance or cost-effectiveness until in the future prospectively designed study related the anti-HER2 therapy after local brain therapy will be come up.

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