Leptomeningeal Metastasis in ER+HER2- Advanced Breast Cancer Patients: A Review of the Cases in a Single Institute Over a 14-year Period

2021 ◽  
Author(s):  
Junichiro Watanabe ◽  
Koichi Mitsuya ◽  
Shogo Nakamot0 ◽  
Hideyuki Harada ◽  
Shoichi Deguchi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Systemic Therapy ◽  
Performance Status ◽  
Hazard Ratio ◽  
Advanced Breast ◽  
Cancer Center ◽  
Breast Cancer Patients ◽  
Cns Metastases ◽  
Cns Lesions

Abstract Purpose: While leptomeningeal metastases (LM) from estrogen receptor-positive, HER2-negative advanced breast cancer (ER+HER2-ABC) has a poor prognosis, the details of LM ER+HER2- are unclear. We therefore retrospectively investigated patients with LM from ER+HER2-ABC.Methods: ER+HER2-ABC patients who received any therapy at Shizuoka Cancer Center between October 2002 and December 2017 were retrospectively analyzed. Patients with central nervous system (CNS) metastases were divided into three groups: brain metastasis (BM) only (B group); BM with LM (BL group); and LM only (L group).Results: Among 369 patients, 102 developed CNS metastases: 70 (68.6%), 13 (12.8%), and 19 (18.6%) in the B, BL, and L groups, respectively. The L group showed a later onset, poorer performance status, more symptoms, and more skull metastasis than the other groups. Radiotherapy as the initial treatment was introduced to 13/13 (100%) and 15/19 (78.9%) in the BL and L groups, respectively. Subsequent systemic therapy excluding best supportive care was introduced to 5/13 (38.5%) and 5/19 (26.3%) in the BL and L groups, respectively. The median overall survival (OS) from the diagnosis of CNS lesions was 295.0, 146.0, and 99.0 days in the B, BL, and L groups, respectively, and worsening of CNS lesions was the major cause of death in the BL and L groups. Multivariate analyses showed that concurrent soft tissue metastasis (hazard ratio, 4.620) and subsequent systemic therapy (hazard ratio, 0.063) were prognostic for the L group.Conclusion: Management of LM from ER+HER2-ABC remains challenging, so a multimodal approach with novel systemic therapy is warranted.

Development and validation of a nomogram for predicting survival of advanced breast cancer patients in China.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13064-e13064
Author(s):  
Shaoyan Lin ◽  
Hongnan Mo ◽  
Yiqun Li ◽  
Xiuwen Guan ◽  
Yimeng Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Multivariate Analyses ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Local Therapy ◽  
Advanced Breast ◽  
Cancer Center ◽  
Breast Cancer Patients ◽  
Ecog Performance Status

e13064 Background: The prognosis of patients with advanced breast cancer (ABC) varied according to different prognostic factors. This study aimed to establish a nomogram to predict the overall survival (OS) of ABC patients in China. Methods: Data from the China National Cancer Center database that recorded 4039 patients diagnosed with breast cancer between 1987 and 2019 were extracted and a total of 2263 ABC patients with complete relevant information were included in this study, which were further randomized 3:1 and divided into training ( n = 1706) and validation ( n = 557) cohorts. The nomogram was built based on independent predictors identified by univariate and multivariate analyses. Harrell′s concordance index (C-index) and calibration plots were used to assessed the discriminatory and predictive capacities of the nomogram. Results: With a median OS of 45.4 months, the 2-year and 3-year OS rates of ABC patients were 75.2% and 60.2%, respectively. Univariate and multivariate analyses found that age, Eastern Cooperative Oncology Group (ECOG) performance status, T-stage, N-stage, tumor subtype, the presence of distant lymph node (DLN)/liver/brain metastasis, local therapy, efficacy of first-line therapy and metastatic-free interval (MFI) were significantly associated with OS (all P < 0.05). These variables were incorporated into a nomogram to predict the 2-year and 3-year OS of ABC patients. The C-indexes of the nomogram were 0.700 (95% confidence interval [CI]: 0.683-0.717) and 0.686 (95% CI: 0.652-0.719) for the training and the validation sets, respectively. The calibration curves revealed satisfactory agreement between actual survival and nomogram prediction in both the internal and external validations. The nomogram was able to stratify patients into different risk groups. Conclusions: We developed and validated a nomogram that might serve as an efficient tool to provide individual prediction for ABC patients and guide the physicians to make personalized treatment decisions for individual ABC patients.

Vinorelbine as Single Agent in Pretreated Patients with Advanced Breast Cancer

1994 ◽  
Vol 80 (4) ◽  
pp. 280-282 ◽  
Author(s):  
Sandro Barni ◽  
Antonio Ardizzoia ◽  
Gianni Bernardo ◽  
Silvia Villa ◽  
Maria Rosa Strada ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Cancer Patients ◽  
Performance Status ◽  
Single Agent ◽  
Vinca Alkaloid ◽  
Advanced Breast ◽  
Weekly Dose ◽  
Weekly Schedule ◽  
Breast Cancer Patients

Vinorelbine is a new semisynthetic vinca alkaloid with high activity against breast cancer. In this multicenter clinical study we evaluated the activity and toxicity of vinorelbine as a single agent in 30 advanced breast cancer patients pretreated with anthracycline and/or mitoxantrone (24 with recurrent tumor, 6 with non operable cancers). Vinorelbine was given at a weekly dose of 20 mg/m2 for a minimum of 3 weeks. Treatment was continued until there was disease progression or evidence of serious toxicity. Predominant sites of metastasis were viscera (14 cases), soft tissue (11 cases) and bone (5 cases). A median number of 12 doses of vinorelbine (range 3-34) were administered to each patient. Objective responses were recorded in 11 of them and 15 had minimal responses or stable disease. Four patients showed progression of disease during vinorelbine chemotherapy. The median duration of response was 5 months (2-14). The median survival time was 7 months (2-20+): 9 months for responders and 5 months for those with stable or progressive disease. The most important and dose-limiting toxicity was represented by leukopenia. The compliance of patients was very good and the treatment was well accepted by them all including those with low performance status. In conclusion, this study provides further evidence that a weekly schedule with vinorelbine as a single agent is effective and well-tolerated also in pretreated advanced breast cancer patients.

Significance of serum tumor markers in monitoring advanced breast cancer patients treated with systemic therapy: A prospective study

Breast Cancer ◽  
2004 ◽  
Vol 11 (4) ◽  
pp. 389-395 ◽  
Author(s):  
Junichi Kurebayashi ◽  
Reiki Nishimura ◽  
Katsuhiro Tanaka ◽  
Norio Kohno ◽  
Masafumi Kurosumi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prospective Study ◽  
Advanced Breast Cancer ◽  
Cancer Patients ◽  
Tumor Markers ◽  
Systemic Therapy ◽  
Advanced Breast ◽  
Breast Cancer Patients ◽  
Serum Tumor Markers ◽  
A Prospective Study

Weekly Epirubicin in Advanced Breast Cancer

1988 ◽  
Vol 74 (6) ◽  
pp. 689-692 ◽  
Author(s):  
Enrico Tucci ◽  
Renato Algeri ◽  
Alfredo Guarnieri ◽  
Fiorella Pepi ◽  
Lidia Sapio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Performance Status ◽  
Poor Performance ◽  
Cytotoxic Chemotherapy ◽  
Advanced Breast ◽  
Poor Performance Status ◽  
Weekly Schedule ◽  
Breast Cancer Patients ◽  
Duration Of Response

Twenty-nine advanced breast cancer patients, considered unable to tolerate conventional cytotoxic chemotherapy, were treated with a weekly schedule of epirubicin (15 mg/m2 i.v.). All patients were fully evaluable. A remission of 34.5 % was observed (2 CR; 8 PR), with a median duration of response of 9 months (range, 3–24 months). Side effects were mild, and on the whole the toxicity was negligible. This regimen showed a favorable therapeutic ratio in our series and seems active and well tolerated even in elderly and/or poor performance status patients.

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