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Multifactorial central nervous system recurrence susceptibility in patients with HER2‐positive breast cancer
Cancer, 2011-05, Vol.117 (9), p.1837-1846
Musolino, Antonino
Ciccolallo, Laura
Panebianco, Michele
Fontana, Elisa
Zanoni, Daniele
Bozzetti, Cecilia
Michiara, Maria
Silini, Enrico Maria
Ardizzoni, Andrea
2011
Details
Autor(en) / Beteiligte
Musolino, Antonino
Ciccolallo, Laura
Panebianco, Michele
Fontana, Elisa
Zanoni, Daniele
Bozzetti, Cecilia
Michiara, Maria
Silini, Enrico Maria
Ardizzoni, Andrea
Titel
Multifactorial central nervous system recurrence susceptibility in patients with HER2‐positive breast cancer
Ist Teil von
Cancer, 2011-05, Vol.117 (9), p.1837-1846
Ort / Verlag
Hoboken: Wiley Subscription Services, Inc., A Wiley Company
Erscheinungsjahr
2011
Link zum Volltext
Quelle
Free E-Journal (出版社公開部分のみ)
Beschreibungen/Notizen
BACKGROUND: A series of retrospective studies have reported that patients with human epidermal growth factor receptor 2(HER2)‐positive breast cancer are at a greater risk of central nervous system (CNS) metastases. Trastuzumab, which does not cross the blood‐brain barrier, has been associated with this increased risk. METHODS: The authors evaluated incidence, survival, and risk factors for CNS metastases in the incident breast cancer population systematically collected by the Parma Province Cancer Registry over the 4‐year period between 2004 and 2007. RESULTS: A total of 1458 patients with a diagnosis of stage I to III invasive breast cancer were analyzed for study purposes. At a median follow‐up of 4.1 years, CNS events were observed in 1.3% and 5% of HER2‐negative patients and HER2‐positive patients, respectively (P < .0001). The administration of trastuzumab either as adjuvant therapy or for metastatic disease was associated with a significantly increased risk of CNS involvement at first disease recurrence and after first extracranial recurrence, respectively. According to multivariate analysis, HER2‐positive status and trastuzumab treatment, high Ki‐67 index, and hormone receptor negativity remained independent risk factors for the development of CNS metastasis. CONCLUSIONS: To the authors' knowledge, this is the first population‐based cancer registry study analyzing factors associated with CNS recurrence in a general population of newly diagnosed breast cancer patients with known HER2 status. The data from the current study provide evidence that patients with HER2‐positive breast cancer have a significantly higher incidence of CNS metastasis after treatment with trastuzumab. Improvements in systemic control and overall survival associated with trastuzumab‐based therapy may lead to an “unmasking” of CNS disease recurrence that would otherwise remain clinically silent before a patient's death. Cancer 2011. © 2010 American Cancer Society. This cancer registry study provides evidence that patients with human epidermal growth factor receptor 2 (HER2)‐positive breast cancer have a significantly high incidence of central nervous system (CNS) metastasis after treatment with trastuzumab. The putative increase in CNS disease in women with HER2‐positive breast cancer appears to be multifactorial, and can include both inherent biological factors and treatment‐related factors.
Sprache
Englisch
Identifikatoren
ISSN: 0008-543X
eISSN: 1097-0142
DOI: 10.1002/cncr.25771
Titel-ID: cdi_wiley_primary_10_1002_cncr_25771_CNCR25771
Format
–
Schlagworte
breast cancer
,
central nervous system (CNS) metastases
,
human epidermal growth factor receptor 2 (HER‐2)
,
multifactorial
,
trastuzumab
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