Multi-institutional report of trastuzumab deruxtecan and stereotactic radiosurgery for HER2 positive and HER2-low breast cancer brain metastases.

IF 6.5 2区医学 Q1 ONCOLOGY

NPJ Breast Cancer Pub Date : 2024-11-21 DOI:10.1038/s41523-024-00711-w

Vaseem M Khatri, Mariella A Mestres-Villanueva, Sreenija Yarlagadda, Ajay Doniparthi, David B Smith, Justyn Y Nakashima, John M Bryant, Dekuang Zhao, Rituraj Upadhyay, Matthew N Mills, Daniel E Oliver, Hsiang-Hsuan Michael Yu, Joshua D Palmer, Nicole O Williams, Reshma L Mahtani, Manmeet S Ahluwalia, Hatem H Soliman, Hyo S Han, Aixa E Soyano, Youngchul Kim, Rupesh Kotecha, Sasha J Beyer, Kamran A Ahmed

{"title":"Multi-institutional report of trastuzumab deruxtecan and stereotactic radiosurgery for HER2 positive and HER2-low breast cancer brain metastases.","authors":"Vaseem M Khatri, Mariella A Mestres-Villanueva, Sreenija Yarlagadda, Ajay Doniparthi, David B Smith, Justyn Y Nakashima, John M Bryant, Dekuang Zhao, Rituraj Upadhyay, Matthew N Mills, Daniel E Oliver, Hsiang-Hsuan Michael Yu, Joshua D Palmer, Nicole O Williams, Reshma L Mahtani, Manmeet S Ahluwalia, Hatem H Soliman, Hyo S Han, Aixa E Soyano, Youngchul Kim, Rupesh Kotecha, Sasha J Beyer, Kamran A Ahmed","doi":"10.1038/s41523-024-00711-w","DOIUrl":null,"url":null,"abstract":"<p><p>Trastuzumab-deruxtecan (T-DXd) has demonstrated intracranial efficacy; however, safety and efficacy data remains limited with stereotactic radiosurgery (SRS). A multi-institutional review was performed with HER2+ or HER2-low metastatic breast cancer treated with T-DXd and SRS for active brain metastases. We identified 215 lesions treated over 48 SRS courses in 34 patients. Median follow up from T-DXd initiation was 13.9 months. The cumulative incidence of symptomatic radiation necrosis at 24 months per lesion was 2.1% and per patient 11%. The 12-month LC was 97%. HER2-low was associated with worse distant intracranial control (DIC) (adjusted HR 2.5, 95% CI 1.1-5.6, p = 0.03) and worse systemic progression free survival (PFS) (HR 4.1, 95% CI 1.6-10.7, p = 0.004). Concurrent SRS and T-DXd has excellent local control, without an increased risk of radiation necrosis. HER2-low disease is associated with worse systemic PFS and DIC with T-DXd compared to HER2+.</p>","PeriodicalId":19247,"journal":{"name":"NPJ Breast Cancer","volume":"10 1","pages":"100"},"PeriodicalIF":6.5000,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11582691/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"NPJ Breast Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41523-024-00711-w","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Trastuzumab-deruxtecan (T-DXd) has demonstrated intracranial efficacy; however, safety and efficacy data remains limited with stereotactic radiosurgery (SRS). A multi-institutional review was performed with HER2+ or HER2-low metastatic breast cancer treated with T-DXd and SRS for active brain metastases. We identified 215 lesions treated over 48 SRS courses in 34 patients. Median follow up from T-DXd initiation was 13.9 months. The cumulative incidence of symptomatic radiation necrosis at 24 months per lesion was 2.1% and per patient 11%. The 12-month LC was 97%. HER2-low was associated with worse distant intracranial control (DIC) (adjusted HR 2.5, 95% CI 1.1-5.6, p = 0.03) and worse systemic progression free survival (PFS) (HR 4.1, 95% CI 1.6-10.7, p = 0.004). Concurrent SRS and T-DXd has excellent local control, without an increased risk of radiation necrosis. HER2-low disease is associated with worse systemic PFS and DIC with T-DXd compared to HER2+.

查看原文本刊更多论文

曲妥珠单抗德鲁司坦和立体定向放射外科治疗 HER2 阳性和 HER2 阴性乳腺癌脑转移的多机构报告。

曲妥珠单抗-德鲁司康（T-DXd）具有颅内疗效，但立体定向放射手术（SRS）的安全性和疗效数据仍然有限。我们对使用 T-DXd 和 SRS 治疗活动性脑转移灶的 HER2+ 或 HER2-Low 转移性乳腺癌进行了多机构回顾。我们在 34 名患者的 48 个 SRS 疗程中发现了 215 个病灶。从 T-DXd 开始的中位随访时间为 13.9 个月。24个月时，每个病灶的无症状放射性坏死累积发生率为2.1%，每位患者的累积发生率为11%。12个月的LC为97%。HER2低与较差的颅内远处控制（DIC）（调整后HR 2.5，95% CI 1.1-5.6，p = 0.03）和较差的全身无进展生存期（PFS）（HR 4.1，95% CI 1.6-10.7，p = 0.004）相关。同期SRS和T-DXd具有良好的局部控制效果，且不会增加放射坏死的风险。与HER2+相比，HER2-low疾病与T-DXd的全身PFS和DIC较差有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

NPJ Breast Cancer Medicine-Pharmacology (medical)

CiteScore

10.10

自引率

1.70%

发文量

122

审稿时长

9 weeks

期刊介绍： npj Breast Cancer publishes original research articles, reviews, brief correspondence, meeting reports, editorial summaries and hypothesis generating observations which could be unexplained or preliminary findings from experiments, novel ideas, or the framing of new questions that need to be solved. Featured topics of the journal include imaging, immunotherapy, molecular classification of disease, mechanism-based therapies largely targeting signal transduction pathways, carcinogenesis including hereditary susceptibility and molecular epidemiology, survivorship issues including long-term toxicities of treatment and secondary neoplasm occurrence, the biophysics of cancer, mechanisms of metastasis and their perturbation, and studies of the tumor microenvironment.