ASCO 2007 - Study found Patients with CNS mets lived longer than those without

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Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings Part I. Vol 25, No. 18S (June 20 Supplement), 2007: 1017

Author(s):

S. Verma, J. S. Azzi, L. A. Vandermeer, J. N. Spaans

Abstract:

Background: Several studies have documented an increase in the incidence of CNS mets in HER2+ MBC pts (Bendell, 2003; Heinrich, 2003). Of interest is whether there are any specific patterns of CNS metastasis and if they have an impact on survival. Methods: This retrospective study included 100 HER2+ MBC pts who received trastuzumab with or without chemotherapy for their disease between Jan 1/00 and Jan 1/05. Pts were selected for the presence (n=50) or absence (n=50) of CNS mets. Demographics, location of mets and timeline-related variables (survival) were compared. Results: In 50 MBC pts with CNS mets, the most common site was the cerebellum (82%); and symptoms were related to increased intracranial pressure, primarily as a result of disease-related cerebral edema (73%). Compared to 50 pts without CNS mets, there was no statistically significant difference in overall survival from the time of initial diagnosis of breast cancer. Of interest, pts with CNS mets lived longer (61.3 months) than pts without CNS mets (47.1 months). However, survival after disease progression or recurrence significantly favoured patients with CNS mets (36.8 months v. 22.0 months respectively; p=0.02). Causes of death in both cohorts were also examined. Conclusions: In our observation, CNS mets did not have an adverse effect on overall survival. In fact, pts who developed CNS mets lived longer than those pts without CNS mets. This may in part be due to more aggressive management of CNS mets, or lack of extracranial progression.