ment characterized, both in terms of how it delays time to brain mets and how it increases survival after brain mets. This study involved Asian patients in six countries and found herceptin AND lapatinib beneficial
http://www.nature.com/bjc/journal/v1...c2012346a.html
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Clinical Study
BJC Open article
British Journal of Cancer (2012) 107, 1075–1082. doi:10.1038/bjc.2012.346
www.bjcancer.com
Published online 23 August 2012
Brain metastases in Asian HER2-positive breast cancer patients: anti-HER2 treatments and their impact on survival
Y S Yap1, G H Cornelio2, B C R Devi3, C Khorprasert4, S B Kim5, T Y Kim6, S C Lee7, Y H Park8, J H Sohn9, N Sutandyo10, D W Y Wong11, M Kobayashi12, S H Landis13, E M Yeoh14, H Moon15 and J Ro16
1Department of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore
2Saint Peregrine Oncology Unit, San Juan de Dios Hospital, 2772 Roxas Boulevard, Pasay City 1300, Philippines
3Department of Radiotherapy, Oncology and Palliative Care, Sarawak General Hospital, Kuching 93586, Malaysia
4Division of Radiation Oncology, Faculty of Medicine, Chulalongkorn University, Rama 4 Road, Bangkok 10330, Thailand
5Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea
6Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea
7Department of Haematology-Oncology, National University Health System, 1E Kent Ridge Road, Singapore 119228, Singapore
8Samsung Medical Center, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea
9Severance Hospital, Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
10Dharmais Hospital National Cancer Center, Jl. Let. Jend. S. Parman Kav. 84-86, Slipi, Jakarta Barat 11420, Indonesia
11Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
12GlaxoSmithKline, 5 Moore Drive 17.2136K.2A, Research Triangle Park, NC 27709, USA
13European Medical Affairs, GlaxoSmithKline, 1-3 Iron Bridge Road, Uxbridge, Middlesex UB11 1BT, UK
14Oncology R&D, GlaxoSmithKline Pte Ltd, 150 Beach Road, Gateway West, Singapore 189720, Singapore
15GlaxoSmithKline (China) R&D Co. Ltd, 917 Halei Road, Zhangjiang Hi-Tech Park, Pudong, Shanghai 201203, China
16National Cancer Center, 111 Jeongbalsanro, Ilsan-gu, Goyang-si, Gyeonggi-do 410-769, Korea
Correspondence: Dr J Ro, E-mail:
jungsro@ncc.re.kr
Received 14 March 2012; Revised 10 July 2012; Accepted 13 July 2012
Advance online publication 23 August 2012
Background:
In Asia, large-scale studies on anti-HER2 treatment in HER2-positive breast cancer patients with brain metastases are limited. We studied the treatment patterns of these patients in Asia to evaluate the impact of anti-HER2 treatment on the time to occurrence of brain metastases (TTBM) and survival after brain metastasis (BM).
Methods:
A retrospective study of HER2-positive breast cancer patients diagnosed with BM between January 2006 and December 2008 in six Asian countries was conducted. Demographics, tumour characteristics, treatment details, and events dates were collected from medical records.
Results:
Data from 280 patients were analysed. Before BM, 63% received anti-HER2 treatment. These patients had significantly longer TTBM than those without anti-HER2 treatment (median 33 vs 19 months; P<0.002). After BM, 93% received radiotherapy, 57% received chemotherapy, and 41% received anti-HER2 treatment (trastuzumab and/or lapatinib). Use of both anti-HER2 agents, primarily sequentially, after BM demonstrated the longest survival after BM and was associated with a significant survival benefit over no anti-HER2 treatment (median 26 vs 6 months; hazard ratio 0.37; 95% CI 0.19–0.72).
Conclusion:
Anti-HER2 treatment before BM was associated with longer TTBM. Anti-HER2 treatment after BM was associated with a survival benefit, especially when both trastuzumab and lapatinib were utilised.
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