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Great news for those who have survived 5 years (even if stage IV)--risk of brain mets

now is tiny!!! at least according to this abstract's experience in Serbia

The risk for brain metastases in HER2 3+ BC five years after primary BC diagnosis.

Sub-category:
HER2+

Category:
Breast Cancer - HER2/ER

Meeting:
2011 ASCO Annual Meeting

Abstract No:
e11091

Citation:
J Clin Oncol 29: 2011 (suppl; abstr e11091)

Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2011 Annual Meeting but not presented at the Meeting, can be found online only.

The publication-only abstracts are not included in the print or USB versions of the ASCO Annual Meeting Proceedings Part I, but they are citable to the Journal of Clinical Oncology as a supplement (see citation on left).

Author(s): Z. Tomasevic, Z. Kovac, Z. Milovanovic, D. Gavrilovic; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia and Montenegro

Abstract Disclosures

Abstract:

Background: More than 30% of HER2 3+ BC develops brain metastases (BM) eventually, usually in the first 2-3 years after BC diagnosis. Risk for distant metastases in HER2 3+ BC remains for many years, but there are no data regarding the long term risk for BM The aim of this analysis is to is to explore whether risk for late BM, defined as BM relapse after 5 years of diagnosis) differs between patients with HER2 3+ and HER2- BC. Methods: Between January 2007-January 2011, 133 consecutive BC BM pts were identified. Patients were evaluated for age, ER/PGR/HER2 status, time to BM and BM as first relapse site according to HER2 status. BM as a first relapse site also includes BM diagnosed within 2 months after metastases in other organs developed. Results: Median age was 49 years (range 25-79); HER2 status (HercepTest, Dako) was known for 118 pts (88.7%) and they are considered for this analysis. HER 2 3+ was confirmed in 40 (34 %), HER2 0-2+ (2+ confirmed by CISH) in 78 (66%) and triple negative status in 19 (16 %) pts. Median time to BM in HER2 negative pts was 36 months (range 0-252).Median time to BM in HER2 3+ BC was 25 months (range 0-96); 39/40 (97,5%) HER2 3+ pts developed BM within 0-60 months, and only 1 MBC pt developed BM 96 months after BC diagnosis. That unique MBC patient, treated with trastuzumab for 8 years developed infra-tentorial BM as a terminal event. Conclusions: There is a striking difference in late BM development between HER2 3+ and HER2 negative BC. For some reason, HER2 3+ BC does not or extremely rarely metastasize to the brain 5 yrs after BC diagnosis, even if metastases in the other organ sites are present. It seems that if HER2 3+ pt survive > 5 yrs without metastases, BM development is highly unlikely. Risk for BM in HER2 negative pts is retained for many years (up to 21 yrs), even as a first relapse site. These results could be important for potential future prophylactic BM strategies.