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Impact of breast cancer molecular subtypes on the incidence, kinetics and prognosis of central nervous system metastases in a large multicentre real-life cohort.
- Source :
-
British journal of cancer [Br J Cancer] 2019 Dec; Vol. 121 (12), pp. 991-1000. Date of Electronic Publication: 2019 Nov 13. - Publication Year :
- 2019
-
Abstract
- Background: Metastatic breast cancer (MBC) behaviour differs depending on hormone receptors (HR) and human epidermal growth factor receptor (HER2) statuses.<br />Methods: The kinetics of central nervous system (CNS) metastases (CNS metastasis-free survival, CNSM-FS) and subsequent patient's prognosis (overall survival, OS) according to the molecular subtype were retrospectively assessed in 16703 MBC patients of the ESME nationwide multicentre MBC database (Kaplan-Meier method).<br />Results: CNS metastases occurred in 4118 patients (24.6%) (7.2% at MBC diagnosis and 17.5% later during follow-up). Tumours were HER2-/HR+ (45.3%), HER2+/HR+ (14.5%), HER2+/HR- (14.9%) and triple negative (25.4%). Median age at CNS metastasis diagnosis was 58.1 years (range: 22.8-92.0). The median CNSM-FS was 10.8 months (95% CI: 16.5-17.9) among patients who developed CNS metastases. Molecular subtype was independently associated with CNSM-FS (HR = 3.45, 95% CI: 3.18-3.75, triple-negative and HER2-/HR+ tumours). After a 30-month follow-up, median OS after CNS metastasis diagnosis was 7.9 months (95% CI: 7.2-8.4). OS was independently associated with subtypes: median OS was 18.9 months (HR = 0.57, 95% CI: 0.50-0.64) for HER2+/HR+ , 13.1 months (HR = 0.72, 95% CI: 0.65-0.81) for HER2+/HR-, 4.4 months (HR = 1.55, 95% CI: 1.42-1.69) for triple-negative and 7.1 months for HER2-/HR+ patients (p <0.0001).<br />Conclusions: Tumour molecular subtypes strongly impact incidence, kinetics and prognosis of CNS metastases in MBC patients.<br />Clinical Trial Registration: NCT03275311.
- Subjects :
- Adult
Aged
Aged, 80 and over
Breast Neoplasms, Male classification
Breast Neoplasms, Male genetics
Breast Neoplasms, Male pathology
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Kinetics
Male
Middle Aged
Neoplasm Metastasis
Nervous System Neoplasms genetics
Nervous System Neoplasms pathology
Nervous System Neoplasms secondary
Prognosis
Receptor, ErbB-2 genetics
Triple Negative Breast Neoplasms classification
Triple Negative Breast Neoplasms genetics
Triple Negative Breast Neoplasms pathology
Young Adult
Breast Neoplasms, Male epidemiology
Nervous System Neoplasms epidemiology
Triple Negative Breast Neoplasms epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-1827
- Volume :
- 121
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- British journal of cancer
- Publication Type :
- Academic Journal
- Accession number :
- 31719684
- Full Text :
- https://doi.org/10.1038/s41416-019-0619-y