Brain metastases in patients who receive trastuzumab-containing chemotherapy for HER2

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Brain metastases in patients who receive trastuzumab-containing chemotherapy for HER2-overexpressing metastatic breast cancer
International Journal of Clinical Oncology, 02/25/09

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Ono M et al. - In a trial to examine risk factors for development of brain metastasis in pts with HER2-overexpressing breast cancer who were treated with trastuzumab, it was shown that these pts had a high incidence of brain metastases (36.3%). Routine screening for brain metastases 1 yr after the start of trastuzumab treatment may be warranted in younger pts (≤50 yrs) who had recurrent breast cancer with liver metastases. Methods 204 pts with HER-2-overexpressing breast cancer who were treated with a trastuzumab-containing regimen were reviewed. Pts with clinical symptoms were diagnosed as having brain metastases when brain magnetic resonance imaging (MRI) or a computed tomography (CT) scan revealed positive findings for brain metastases. Median follow-up time of this cohort was 53.6 mos. Results Among the pts who received a trastuzumabcontaining regimen, 74 pts (36.3%) developed brain metastases. Median survival from diagnosis of brain metastases was 13.5 mos. Median time between beginning of trastuzumab treatment and diagnosis of brain metastases was 13.6 mos. Among pts with brain metastases, median overall survival period was 39 mos. A multivariate logistic regression analysis showed that age (≤50 yrs), recurrent breast cancer, and liver metastases were significant risk factors for development of brain metastases.