Brain metastases in patients who receive trastuzumab-containing chemotherapy for HER2-overexpressing metastatic breast cancer
Brain metastases in patients who receive trastuzumab-containing chemotherapy for HER2-overexpressing metastatic breast cancer
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DOI：
10.1007/s10147-008-0797-8
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发表时间：
2009-02-01
影响因子：
3.3
通讯作者：
Fujiwara, Yasuhiro
中科院分区：
文献类型：
--
作者：
Ono, Makiko;Ando, Masashi;Fujiwara, Yasuhiro
最近，在接受曲妥珠单抗治疗的人表皮生长因子受体（HER 2）过表达转移性乳腺癌患者中报告了高脑转移率。本研究探讨了HER-2过表达乳腺癌患者接受曲妥珠单抗治疗后发生脑转移的危险因素，我们回顾性分析了1999年至2006年间接受含曲妥珠单抗治疗的204例HER-2过表达乳腺癌患者。当脑磁共振成像（MRI）或计算机断层扫描（CT）显示脑转移阳性时，有临床症状的患者被诊断为脑转移。该队列的中位随访时间为53.6个月，在接受含曲妥珠单抗方案的患者中，74例（36.3%）发生脑转移。诊断为脑转移后的中位生存期为13.5个月（95%置信区间[CI]，12.2-14.7个月）。曲妥珠单抗治疗开始与脑转移诊断之间的中位时间间隔为13.6个月（范围：0.0-45.8个月）。脑转移患者的中位总生存期为39个月。多因素Logistic回归分析显示年龄（千分之一货币符号50岁）、复发性乳腺癌和肝转移是脑转移的重要危险因素，HER 2过表达的乳腺癌患者接受曲妥珠单抗治疗后脑转移的发生率较高（36.3%）。对于复发性乳腺癌伴肝转移的年轻患者（千分之一货币符号50岁），可能需要在曲妥珠单抗治疗开始后1年进行脑转移的常规筛查。
Recently, a high rate of brain metastases has been reported among patients with human epidermal growth factor receptor (HER2)-overexpressing metastatic breast cancer who were treated with trastuzumab. The present study examined risk factors for the development of brain metastasis in patients with HER2-overexpressing breast cancer who were treated with trastuzumab.We retrospectively reviewed 204 patients with HER-2-overexpressing breast cancer who were treated with a trastuzumab-containing regimen between 1999 and 2006. Patients 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. The median follow-up time of this cohort was 53.6 months.Among the patients who received a trastuzumabcontaining regimen, 74 patients (36.3%) developed brain metastases. The median survival from the diagnosis of brain metastases was 13.5 months (95% confidence interval [CI], 12.2-14.7 months). The median time interval between the beginning of trastuzumab treatment and the diagnosis of brain metastases was 13.6 months (range, 0.0-45.8 months). Among patients with brain metastases, the median overall survival period was 39 months. A multivariate logistic regression analysis showed that age (a parts per thousand currency sign50 years), recurrent breast cancer, and liver metastases were significant risk factors for the development of brain metastases.Patients with HER2-overexpressing breast cancer treated with trastuzumab had a high incidence of brain metastases (36.3%). Routine screening for brain metastases 1 year after the start of trastuzumab treatment, may be warranted in younger patients (a parts per thousand currency sign50 years) who had recurrent breast cancer with liver metastases.