Clinicopathological study of brain metastases in breast cancer patients treated with or without trastuzumab

Abstract

693 Background: Trastuzumab plays the important role in the treatment of patients with HER2 overexpressing metastatic breast cancer. Since its introduction into the treatment strategy of metastatic breast cancer, brain metastases during trastuzumab therapy have been frequently observed. Only a few studies have compared the risk of brain metastases in patients treated with or without trastuzumab. Methods: We conducted the retrospective and clinicopathological study of the fifty-seven patients with brain metastases treated in our hospital between 1989 and 2003. Those fourteen patients with brain metastases were surgically removed to be pathologically compared with primary tumors. Results: Twenty-seven patients were positive for HER2, while the remaining thirty patients were negative. The time from the first recurrence to brain metastases and the median overall survival time were not significantly different between HER2 positive and negative patients. Nineteen patients were treated with the trastuzumab-based therapy out of twenty seven HER2 positive patients. The time from the first recurrence to brain metastases was 17.4months for those patients who received trastuzumab-based therapy, while 8.3 months for the patients who did not receive trastuzumab (p<0.01). The survival period after brain metastases was 9.8months for the patients who received trastuzumab, while 1.1 months for the patients who did not receive trastuzumab (p<0.01). The median overall survival period was 51.8 month for those patients who received trastuzumab and 34.4 months for the patients who did not received trastuzumab(p<0.01). The fourteen tumors of the brain had the same HER2 status to primary tumors, except one tumor changed negative. Conclusions: This study showed that trastuzumab patients with brain metastases have survived significantly longer interval after first recurrence and the development of brain metastases, when comparing with control group. No significant financial relationships to disclose.