Incidence of brain metastases in patients with early HER2-positive breast cancer receiving neoadjuvant chemotherapy with trastuzumab and pertuzumab
Abstract The addition of pertuzumab (P) to trastuzumab (H) and neoadjuvant chemotherapy (NAC) has decreased the risk of distant recurrence in early stage HER2-positive breast cancer. The incidence of brain metastases (BM) in patients who achieved pathological complete response (pCR) versus those who...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-03-01
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| Series: | npj Breast Cancer |
| Online Access: | https://doi.org/10.1038/s41523-022-00380-7 |
| _version_ | 1797426541589692416 |
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| author | Emanuela Ferraro Jasmeet Singh Sujata Patil Pedram Razavi Shanu Modi Sarat Chandarlapaty Andrea V. Barrio Rachna Malani Ingo K. Mellinghoff Adrienne Boire Hannah Y. Wen Edi Brogi Andrew D. Seidman Larry Norton Mark E. Robson Chau T. Dang |
| author_facet | Emanuela Ferraro Jasmeet Singh Sujata Patil Pedram Razavi Shanu Modi Sarat Chandarlapaty Andrea V. Barrio Rachna Malani Ingo K. Mellinghoff Adrienne Boire Hannah Y. Wen Edi Brogi Andrew D. Seidman Larry Norton Mark E. Robson Chau T. Dang |
| author_sort | Emanuela Ferraro |
| collection | DOAJ |
| description | Abstract The addition of pertuzumab (P) to trastuzumab (H) and neoadjuvant chemotherapy (NAC) has decreased the risk of distant recurrence in early stage HER2-positive breast cancer. The incidence of brain metastases (BM) in patients who achieved pathological complete response (pCR) versus those who do not is unknown. In this study, we sought the incidence of BM in patients receiving HP-containing NAC as well as survival outcome. We reviewed the medical records of 526 early stage HER2-positive patients treated with an HP-based regimen at Memorial Sloan Kettering Cancer Center (MSKCC), between September 1, 2013 to November 1, 2019. The primary endpoint was to estimate the cumulative incidence of BM in pCR versus non-pCR patients; secondary endpoints included disease free-survival (DFS) and overall survival (OS). After a median follow-up of 3.2 years, 7 out of 286 patients with pCR had a BM while 5 out of 240 non-pCR patients had a BM. The 3-year DFS was significantly higher in the pCR group compared to non-pCR group (95% vs 91 %, p = 0.03) and the same trend was observed for overall survival. In our cohort, despite the better survival outcomes of patients who achieved pCR, we did not observe appreciable differences in the incidence of BM by pCR/non-pCR status. This finding suggests that the BM incidence could not be associated with pCR. Future trials with new small molecules able to cross the blood brain barrier should use more specific biomarkers rather than pCR for patients’ selection. |
| first_indexed | 2024-03-09T08:31:44Z |
| format | Article |
| id | doaj.art-5efc975ad4074b27a5124e022f559502 |
| institution | Directory Open Access Journal |
| issn | 2374-4677 |
| language | English |
| last_indexed | 2024-03-09T08:31:44Z |
| publishDate | 2022-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Breast Cancer |
| spelling | doaj.art-5efc975ad4074b27a5124e022f5595022023-12-02T19:41:48ZengNature Portfolionpj Breast Cancer2374-46772022-03-01811810.1038/s41523-022-00380-7Incidence of brain metastases in patients with early HER2-positive breast cancer receiving neoadjuvant chemotherapy with trastuzumab and pertuzumabEmanuela Ferraro0Jasmeet Singh1Sujata Patil2Pedram Razavi3Shanu Modi4Sarat Chandarlapaty5Andrea V. Barrio6Rachna Malani7Ingo K. Mellinghoff8Adrienne Boire9Hannah Y. Wen10Edi Brogi11Andrew D. Seidman12Larry Norton13Mark E. Robson14Chau T. Dang15Breast Cancer Service, Department of Medicine, Memorial Sloan Kettering Cancer CenterBreast Cancer Service, Department of Medicine, Memorial Sloan Kettering Cancer CenterDepartment of Quantitative Health Sciences, Cleveland ClinicBreast Cancer Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine CollegeBreast Cancer Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine CollegeBreast Cancer Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine CollegeBreast Cancer Service, Department of Surgery, Memorial Sloan Kettering Cancer CenterBrain Tumor Center, Department of Neurology, Memorial Sloan Kettering Cancer CenterBrain Tumor Center, Human Oncology and Pathogenesis Program, Department of Neurology, Memorial Sloan Kettering Cancer CenterBrain Tumor Center, Human Oncology and Pathogenesis Program, Department of Neurology, Memorial Sloan Kettering Cancer CenterDepartment of Pathology, Memorial Sloan Kettering Cancer CenterDepartment of Pathology, Memorial Sloan Kettering Cancer CenterBreast Cancer Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine CollegeBreast Cancer Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine CollegeBreast Cancer Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine CollegeBreast Cancer Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine CollegeAbstract The addition of pertuzumab (P) to trastuzumab (H) and neoadjuvant chemotherapy (NAC) has decreased the risk of distant recurrence in early stage HER2-positive breast cancer. The incidence of brain metastases (BM) in patients who achieved pathological complete response (pCR) versus those who do not is unknown. In this study, we sought the incidence of BM in patients receiving HP-containing NAC as well as survival outcome. We reviewed the medical records of 526 early stage HER2-positive patients treated with an HP-based regimen at Memorial Sloan Kettering Cancer Center (MSKCC), between September 1, 2013 to November 1, 2019. The primary endpoint was to estimate the cumulative incidence of BM in pCR versus non-pCR patients; secondary endpoints included disease free-survival (DFS) and overall survival (OS). After a median follow-up of 3.2 years, 7 out of 286 patients with pCR had a BM while 5 out of 240 non-pCR patients had a BM. The 3-year DFS was significantly higher in the pCR group compared to non-pCR group (95% vs 91 %, p = 0.03) and the same trend was observed for overall survival. In our cohort, despite the better survival outcomes of patients who achieved pCR, we did not observe appreciable differences in the incidence of BM by pCR/non-pCR status. This finding suggests that the BM incidence could not be associated with pCR. Future trials with new small molecules able to cross the blood brain barrier should use more specific biomarkers rather than pCR for patients’ selection.https://doi.org/10.1038/s41523-022-00380-7 |
| spellingShingle | Emanuela Ferraro Jasmeet Singh Sujata Patil Pedram Razavi Shanu Modi Sarat Chandarlapaty Andrea V. Barrio Rachna Malani Ingo K. Mellinghoff Adrienne Boire Hannah Y. Wen Edi Brogi Andrew D. Seidman Larry Norton Mark E. Robson Chau T. Dang Incidence of brain metastases in patients with early HER2-positive breast cancer receiving neoadjuvant chemotherapy with trastuzumab and pertuzumab npj Breast Cancer |
| title | Incidence of brain metastases in patients with early HER2-positive breast cancer receiving neoadjuvant chemotherapy with trastuzumab and pertuzumab |
| title_full | Incidence of brain metastases in patients with early HER2-positive breast cancer receiving neoadjuvant chemotherapy with trastuzumab and pertuzumab |
| title_fullStr | Incidence of brain metastases in patients with early HER2-positive breast cancer receiving neoadjuvant chemotherapy with trastuzumab and pertuzumab |
| title_full_unstemmed | Incidence of brain metastases in patients with early HER2-positive breast cancer receiving neoadjuvant chemotherapy with trastuzumab and pertuzumab |
| title_short | Incidence of brain metastases in patients with early HER2-positive breast cancer receiving neoadjuvant chemotherapy with trastuzumab and pertuzumab |
| title_sort | incidence of brain metastases in patients with early her2 positive breast cancer receiving neoadjuvant chemotherapy with trastuzumab and pertuzumab |
| url | https://doi.org/10.1038/s41523-022-00380-7 |
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