Author/Editor		Ratoša, Ivica; Dobnikar, Nika; Bottosso, Michele; Dieci, Maria Vittoria; Jacot, William; Pouderoux, Stéphane; Ribnikar, Domen; Sinoquet, Léa; Guarneri, Valentina; Žnidarič, Tanja
Title		Leptomeningeal metastases in patients with human epidermal growth factor receptor 2 positive breast cancer
Type		članek
Vol. and No.		Letnik 151, št. 8
Publication year		2022
Volume		str. 1355-1366
ISSN		0020-7136 - International journal of cancer : Journal international du cancer
Language		eng
Abstract		In patients with human epidermal growth factor receptor 2 positive (HER2+) breast cancer, leptomeningeal metastases (LM) are a rare but often a fatal clinical scenario. In this multicentric study, clinical and pathologic characteristics of patients with HER2+ breast cancer developing LM were described, as well as survival outcomes. Data were gathered retrospectively from medical records of 82 patients with advanced HER2+ breast cancer and LM treated between August 2005 and July 2020. Following LM diagnosis, 79 (96.3%) patients received at least one line of anti-HER2 therapy, 25 (30.5%) patients received intrathecal therapy and 58 (70.7%) patients received radiotherapy. Overall survival (OS) was 8.3 months (95% confidence interval [CI] 5.7-11), 1-year OS was 42%, and 2-year OS was 21%. At univariate analysis, patients who were treated after 2010, had better Karnofsky performance status, were free of neurological symptoms, had better prognostic, received chemotherapy (OS difference 9.4 months, P = .024), or monoclonal antibodies (trastuzumab ± pertuzumab; OS difference 6.1 months; P = .013) after LM diagnosis, had a statistically significantly longer OS. Presence of neurological symptoms (hazard ratio 3.32, 95% CI 1.26-8.73; P = .015) and not having received radiotherapy (hazard ratio 2.02, 95% CI 1.09-3.72; P = .024) were all associated with poorer OS at multivariate analysis. To summarize, not having neurological symptoms and receiving RT at LM diagnosis were associated with prolonged OS in our cohort. Survival seemed to be prolonged with multimodality treatment, which included targeted therapy, chemotherapy, and RT to the LM sites.
Keywords		anti-HER2 zdravljenje rak dojke receptor 2 humanega epidermalnega rastnega faktorja radioterapija anti-HER2 therapy breast cancer human epidermal growth factor receptor 2 radiotherapy