Outcomes of changing systemic therapy in patients with relapsed breast cancer and 1 to 3 brain metastases

Abstract The development of brain metastases (BMs) in breast cancer (BC) patients remains a challenging complication. Current clinical practice guidelines recommend local treatment of BMs without changing systemic therapy (CST) in patients with stable extracranial disease. We retrospectively investi...

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Autores principales:	Omar Alhalabi, Zaid Soomro, Ryan Sun, Elshad Hasanov, Aya Albittar, Debu Tripathy, Vicente Valero, Nuhad K. Ibrahim
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/b13d01d1e9f04a52984ccf0fe8205030
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spelling	oai:doaj.org-article:b13d01d1e9f04a52984ccf0fe82050302021-12-02T16:30:37ZOutcomes of changing systemic therapy in patients with relapsed breast cancer and 1 to 3 brain metastases10.1038/s41523-021-00235-72374-4677https://doaj.org/article/b13d01d1e9f04a52984ccf0fe82050302021-03-01T00:00:00Zhttps://doi.org/10.1038/s41523-021-00235-7https://doaj.org/toc/2374-4677Abstract The development of brain metastases (BMs) in breast cancer (BC) patients remains a challenging complication. Current clinical practice guidelines recommend local treatment of BMs without changing systemic therapy (CST) in patients with stable extracranial disease. We retrospectively investigated the impact of CST (when applicable as per treating physician’s discretion) following the diagnosis and management of oligometastatic (1–3) BMs in patients without extracranial metastases on the progression-free survival time (PFS), and overall survival (OS). Hazard ratios (HRs) were calculated using the Cox proportional hazard model. Among the 2645 patients with BC and BMs treated between 2002 and 2015, 74 were included for analysis. 40.5% of patients had HER2 + disease. Median time from diagnosis of BC to BMs was 17.6 months. 54%, 8%, and 38% of BMs were managed by radiation, craniotomy, or combination, respectively. Following the primary management of BMs, we observed that CST occurred in 26 (35.5%) patients, consisting of initiation of therapy in 13.5% and switching of ongoing adjuvant therapy in 22%. Median PFS was 6.6 months among patients who had CST compared to 7.1 months in those who did not (HR = 0.88 [0.52–1.47], p = 0.62). Median OS was 20.1 months among patients who had CST compared to 15.1 months in those who did not (HR = 0.68 [0.40–1.16], p = 0.16). Upon the successful local management of oligometastatic BMs in patients without extracranial disease, we did not find a significant difference in survival between patients who experienced a change in systemic therapy as compared to those who did not.Omar AlhalabiZaid SoomroRyan SunElshad HasanovAya AlbittarDebu TripathyVicente ValeroNuhad K. IbrahimNature PortfolioarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENnpj Breast Cancer, Vol 7, Iss 1, Pp 1-5 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Omar Alhalabi Zaid Soomro Ryan Sun Elshad Hasanov Aya Albittar Debu Tripathy Vicente Valero Nuhad K. Ibrahim Outcomes of changing systemic therapy in patients with relapsed breast cancer and 1 to 3 brain metastases
description	Abstract The development of brain metastases (BMs) in breast cancer (BC) patients remains a challenging complication. Current clinical practice guidelines recommend local treatment of BMs without changing systemic therapy (CST) in patients with stable extracranial disease. We retrospectively investigated the impact of CST (when applicable as per treating physician’s discretion) following the diagnosis and management of oligometastatic (1–3) BMs in patients without extracranial metastases on the progression-free survival time (PFS), and overall survival (OS). Hazard ratios (HRs) were calculated using the Cox proportional hazard model. Among the 2645 patients with BC and BMs treated between 2002 and 2015, 74 were included for analysis. 40.5% of patients had HER2 + disease. Median time from diagnosis of BC to BMs was 17.6 months. 54%, 8%, and 38% of BMs were managed by radiation, craniotomy, or combination, respectively. Following the primary management of BMs, we observed that CST occurred in 26 (35.5%) patients, consisting of initiation of therapy in 13.5% and switching of ongoing adjuvant therapy in 22%. Median PFS was 6.6 months among patients who had CST compared to 7.1 months in those who did not (HR = 0.88 [0.52–1.47], p = 0.62). Median OS was 20.1 months among patients who had CST compared to 15.1 months in those who did not (HR = 0.68 [0.40–1.16], p = 0.16). Upon the successful local management of oligometastatic BMs in patients without extracranial disease, we did not find a significant difference in survival between patients who experienced a change in systemic therapy as compared to those who did not.
format	article
author	Omar Alhalabi Zaid Soomro Ryan Sun Elshad Hasanov Aya Albittar Debu Tripathy Vicente Valero Nuhad K. Ibrahim
author_facet	Omar Alhalabi Zaid Soomro Ryan Sun Elshad Hasanov Aya Albittar Debu Tripathy Vicente Valero Nuhad K. Ibrahim
author_sort	Omar Alhalabi
title	Outcomes of changing systemic therapy in patients with relapsed breast cancer and 1 to 3 brain metastases
title_short	Outcomes of changing systemic therapy in patients with relapsed breast cancer and 1 to 3 brain metastases
title_full	Outcomes of changing systemic therapy in patients with relapsed breast cancer and 1 to 3 brain metastases
title_fullStr	Outcomes of changing systemic therapy in patients with relapsed breast cancer and 1 to 3 brain metastases
title_full_unstemmed	Outcomes of changing systemic therapy in patients with relapsed breast cancer and 1 to 3 brain metastases
title_sort	outcomes of changing systemic therapy in patients with relapsed breast cancer and 1 to 3 brain metastases
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/b13d01d1e9f04a52984ccf0fe8205030
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Outcomes of changing systemic therapy in patients with relapsed breast cancer and 1 to 3 brain metastases

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