Biological subtypes and survival outcomes in breast cancer patients with brain metastases (study of the Anatolian Society of Medical Oncology).
BACKGROUND
The aim of this study is to determine the relationship between the survival outcomes and biological subtype in breast cancer patients with brain metastases.


METHODS
We retrospectively evaluated clinical data from 422 breast cancer patients with brain metastases between 2001 and 2011 from referral centers in Turkey. The study population was divided into four biological subtypes according to their hormone receptor status and HER2 expression.


RESULTS
Systemic treatment prolonged median overall survival (OS) after brain metastases in the entire group (14 vs. 3.2 months, p < 0.001). It also prolonged median OS after brain metastases in the triple negative (7.5 vs. 1.6 months, p = 0.010) and luminal A (14.3 vs. 7.1 months, p = 0.003) subgroups. The median OS for untreated patients, chemotherapy and/or hormonal therapy receiving patients, and chemotherapy and/or hormonal therapy plus targeted therapy receivers was 2, 5.8, and 17.7 months, respectively (p < 0.001), in the HER2-overexpressing subgroup. In the luminal B subgroup, it was 3.7, 5.3, and 15.4 months, respectively (p = 0.003).


CONCLUSIONS
The use of systemic therapy improves OS after brain metastases in all biological subgroups. Targeted therapies also improve OS after brain metastases in HER2-positive patients. The combined use of targeted therapies and lapatinib are superior to single use and trastuzumab, respectively, in these patients.
Department of Medical Oncology at Dicle University School of Medicine, Diyarbakir, Turkey. drmalikaplan@hotmail.com
Muhammet Ali
MA
Kaplan
Abdurrahman
A
Isikdogan
Doğan
D
Koca
Mehmet
M
Kucukoner
Ozge
O
Gumusay
Ramazan
R
Yildiz
Adem
A
Dayan
Lütfiye
L
Demir
Caglayan
C
Geredeli
Murat
M
Kocer
Ulku Yalcintas
UY
Arslan
Ali
A
Inal
Olcun Umit
OU
Unal
Aslıhan Guven
AG
Mert
Mehmet
M
Bilici
Metin
M
Ozkan
Emin Tamer
ET
Elkiran
Sebnem
S
Yaman
Ayse Gok
AG
Durnalı
Ali
A
Suner
Suleyman
S
Alici
Mustafa Oktay
MO
Tarhan
Cem
C
Boruban
Zuhat
Z
Urakci
Suleyman
S
Buyukberber
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D000077341:Lapatinib; D008875:Middle Aged; D015999:Multivariate Analysis; D011799:Quinazolines / Q000627:therapeutic use; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D012189:Retrospective Studies; D015996:Survival Rate; D013629:Tamoxifen / Q000627:therapeutic use; D000068878:Trastuzumab; D014421:Turkey
D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000077341:Lapatinib; D011799:Quinazolines; D018719:Erb-b2 Receptor Tyrosine Kinases; D013629:Tamoxifen; D000068878:Trastuzumab; C508053:ERBB2 protein, human