New brain metastases after whole-brain radiotherapy of initial brain metastases in breast cancer patients: the significance of molecular subtypes (KROG 16-12)

Purpose To identify the risk factors leading to new brain metastases (BM) following brain-directed treatment for initial BM resulting from breast cancer (BC). Methods In this multi-institutional study, 538 BC patients with available follow-up imaging after brain-directed treatment for initial BM wer...

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Published in:Breast cancer research and treatment 2021-04, Vol.186 (2), p.453-462
Main Authors: Kim, Jae Sik, Kim, Kyubo, Jung, Wonguen, Shin, Kyung Hwan, Im, Seock-Ah, Kim, Hee-Jun, Kim, Yong Bae, Chang, Jee Suk, Kim, Jee Hyun, Choi, Doo Ho, Park, Yeon Hee, Kim, Dae Yong, Kim, Tae Hyun, Choi, Byung Ock, Lee, Sea-Won, Kim, Suzy, Kwon, Jeanny, Kang, Ki Mun, Chung, Woong-Ki, Kim, Kyung Su, Yoon, Won Sup, Kim, Jin Hee, Cha, Jihye, Oh, Yoon Kyeong, Kim, In Ah
Format: Article
Language:English
Subjects:
Brain cancer
Breast cancer
Cancer
Cancer patients
Cancer research
Care and treatment
Clinical Trial
Epidermal growth factor
ErbB-2 protein
Medicine
Medicine & Public Health
Metastases
Metastasis
Multivariate analysis
Neuroimaging
Oncology
Oncology, Experimental
Radiation therapy
Radiotherapy
Risk factors
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Summary:Purpose To identify the risk factors leading to new brain metastases (BM) following brain-directed treatment for initial BM resulting from breast cancer (BC). Methods In this multi-institutional study, 538 BC patients with available follow-up imaging after brain-directed treatment for initial BM were analyzed. Tumor molecular subtypes were classified as follows: hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2−, n  = 136), HER2-positive (HER2+, n  = 253), or triple-negative BC (TNBC, n  = 149). Results In 37.4% of patients, new BM emerged at a median of 10.5 months after brain-directed treatment for initial BM. The 1-year actuarial rate of new BM for HR+/HER2−, HER2+, and TNBC were 51.9%, 44.0%, and 69.6%, respectively ( p  = 0.008). Initial whole-brain radiotherapy (WBRT) reduced new BM rates (22.5% reduction at 1 year, p  
ISSN:0167-6806
1573-7217
DOI:10.1007/s10549-020-06043-0