Clinical characteristics and prognostic factors in patients with breast cancer and leptomeningeal metastases from a large registry of BMBC

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast Pub Date : 2025-03-28 DOI:10.1016/j.breast.2025.104433

Elena Laakmann , Marcus Schmidt , Kristina Lübbe , Elisa Agostinetto , Mette van Ramshorst , Thomas Decker , Wolfram Malter , Francesco Schettini , Mario Fontes Sousa , Carsten Denkert , Tanja Neunhöffer , Leonor Matos , Sabine Linn , Marc Thill , Rudolf Weide , Amanda Fitzpatrick , Marta Vaz Batista , Christoph Mundhenke , Tjoung-Won Park-Simon , Fanny Le Du , Volkmar Müller

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引用次数: 0

Abstract

Background

Leptomeningeal metastases (LM) in patients with breast cancer (BC) are associated with a dismal prognosis. We explored clinical characteristics and prognostic factors in patients with BC and LM in the German Brain Metastases in Breast Cancer Registry.

Methods

All patients with histologically confirmed BC and diagnosis of LM (defined as the presence of tumor cells in the cerebrospinal fluid, or presence of typical clinical symptoms in combination with typical magnetic resonance imaging findings) were included.

Results

A total of 3857 patients were included in the analysis (n = 859 (22.3 %) with LM). Among patients with LM a median progression-free survival was 4.2 months (95 % CI 3.6–4.8), and median overall survival was 5.7 months (95 % CI 4.9–6.7). In the multivariate analysis older age ( ≥ 60 vs. <60 years, Hazard ratio (HR): 1.65, 95 %CI: 1.25–2.18), worse performance status (ECOG 2–4 vs. 0–1 HR: 2.15, 95 %CI: 1.63–2.82), hormone receptor positive/HER2-negative (HR+/HER2-) or triple-negative subtype (HR: 1.54 95CI%: 1.07–2.23 and HR: 1.87, 95 %CI: 1.25–2.81), and higher number of BM (2–3 vs. 1, HR: 1.49, 95 %CI: 1.05–2.11 4) were significantly associated with a higher risk of death. Stereotactic radiotherapy (HR 0.49 95 %CI 0.30–0.79) and whole brain irradiation (HR: 0.58, 95 %CI: 0.42–0.80), endocrine therapy in patients with HR + BC (HR: 0.31, 95 %CI: 0.21–0.45) as well as HER2-targeted therapy for patients with HER2+ BC (HR 0.41, 95 %CI: 0.25–0.68) were associated with a significantly longer survival.

Conclusions

Clinicopathological factors associated with survival can help clinicians identify patients who are candidates for treatment (de)escalation in clinical trials.

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背景乳腺癌（BC）患者的脑膜转移（LM）与预后不良有关。我们在德国乳腺癌脑转移瘤登记处调查了乳腺癌脑转移瘤患者的临床特征和预后因素。方法所有经组织学确诊为乳腺癌并确诊为脑转移瘤的患者（定义为脑脊液中出现肿瘤细胞，或出现典型的临床症状并结合典型的磁共振成像结果）均纳入调查。LM患者的中位无进展生存期为4.2个月（95 % CI 3.6-4.8），中位总生存期为5.7个月（95 % CI 4.9-6.7）。82）、激素受体阳性/HER2-阴性（HR+/HER2-）或三阴性亚型（HR：1.54 95CI%：1.07-2.23 和 HR：1.87，95 %CI：1.25-2.81）以及较高的 BM 数量（2-3 vs. 1，HR：1.49，95 %CI：1.05-2.11 4）与较高的死亡风险显著相关。立体定向放疗（HR 0.49 95 %CI 0.30-0.79）和全脑照射（HR：0.58，95 %CI：0.42-0.80）、HR + BC 患者的内分泌治疗（HR：0.31，95 %CI：0.21-0.45）以及 HER2+ BC 患者的 HER2 靶向治疗（HR 0.结论与生存相关的临床病理学因素可以帮助临床医生确定哪些患者适合在临床试验中进行治疗（降）级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast 医学-妇产科学

CiteScore

8.70

自引率

2.60%

发文量

165

审稿时长

59 days

期刊介绍： The Breast is an international, multidisciplinary journal for researchers and clinicians, which focuses on translational and clinical research for the advancement of breast cancer prevention, diagnosis and treatment of all stages.