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Breast cancer subtypes linked to survival from secondary brain tumors
February 28, 2008Screening breast cancers for three receptors could help doctors predict the likely survival of patients with brain metastases. A study published in the open access journal Breast Cancer Research shows that patients with tumours that are negative for estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth receptor-2 (HER2) or that are HER2+/ER- appear to be most at risk from developing brain metastases. Survival is also correlated to the triple receptor status.
This is the first time that researchers have documented a possible link between breast cancer subtypes and the incidence and prognosis of brain metastases, which occur in up to one third of metastatic breast cancer patients.
A team from the National Cancer Centre in the Republic of Korea analysed data from 126 patients with brain metastases from a pool of 805 patients diagnosed with metastatic breast cancer and treated at the Centre. The presence or absence of ER, PR and HER2 were tested by immunohistochemical staining and/or fluorescent in situ hybridisation.
More than half of the patients with early (non-metastatic) breast cancer were of the luminal A subtype (ER or PR+ and HER2-). The proportion of patients with HER2+/ER- or triple-negative tumours was significantly higher among patients with brain metastases compared to the early breast cancer population, suggesting that these latter two subtypes were associated with the development of brain metastases.
The analysis also showed a correlation between the survival of patients and their triple receptor subtypes following the diagnosis of brain metastases, the survival time of which is just 3 - 6 months. Patients with luminal A (4.0 months) and triple-negative tumours (3.4 months) had a similar shorter survival time compared with luminal B (ER or PR+ and HER2+; 9.2 months) and HER2+/ER- (5.0 months) tumours.
Patients with HER2-positive tumours experienced a significant survival benefit if they were treated with trastuzumab after their brain metastases were diagnosed.
"Our study suggests that the triple-negative subtype should be added to the list of risk factors for developing BM," remarks Jungsil Ro, the study's corresponding author. "Approximately 10-15% of all breast cancer presents this phenotype; they have a poor prognosis and are more likely to develop brain metastases. Triple receptor status can also help to predict survival even after brain metastases have been diagnosed. We now need to develop ways to screen for these subtypes and find the best ways to manage patients with this more aggressive phenotype."
BioMed Central
More than half of the patients with early (non-metastatic) breast cancer were of the luminal A subtype (ER or PR+ and HER2-). The proportion of patients with HER2+/ER- or triple-negative tumours was significantly higher among patients with brain metastases compared to the early breast cancer population, suggesting that these latter two subtypes were associated with the development of brain metastases.
The analysis also showed a correlation between the survival of patients and their triple receptor subtypes following the diagnosis of brain metastases, the survival time of which is just 3 - 6 months. Patients with luminal A (4.0 months) and triple-negative tumours (3.4 months) had a similar shorter survival time compared with luminal B (ER or PR+ and HER2+; 9.2 months) and HER2+/ER- (5.0 months) tumours.
Patients with HER2-positive tumours experienced a significant survival benefit if they were treated with trastuzumab after their brain metastases were diagnosed.
"Our study suggests that the triple-negative subtype should be added to the list of risk factors for developing BM," remarks Jungsil Ro, the study's corresponding author. "Approximately 10-15% of all breast cancer presents this phenotype; they have a poor prognosis and are more likely to develop brain metastases. Triple receptor status can also help to predict survival even after brain metastases have been diagnosed. We now need to develop ways to screen for these subtypes and find the best ways to manage patients with this more aggressive phenotype."
BioMed Central
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Stereotactic radiosurgery preferred method of treating cancer patients with brain metastases
Cancer patients who receive stereotactic radiosurgery (SRS) and whole brain radiation therapy (WBRT) for the treatment of metastatic brain tumors have more than twice the risk of developing learning and memory problems than those treated with SRS alone, according to researchers at The University of Texas M. D. Anderson Cancer Center.
Whole-brain radiotherapy after surgery or radiosurgery not recommended for brain metastases
Whole-brain radiotherapy should not be given routinely to all patients whose cancer has spread to the brain, say researchers who found that using it after surgery or radiosurgery in patients with a limited number of brain metastases and stable cancer in the rest of the body did not extend lives or help patients remain functionally independent for longer.
Brain irradiation in lung cancer
A national Radiation Therapy Oncology Group (RTOG) study led by a Medical College of Wisconsin Cancer Center physician at Froedtert Hospital in Milwaukee has found that a course of radiation therapy to the brain after treatment for locally advanced non-small cell lung cancer reduced the risk of metastases to the brain within the first year after treatment.
Small molecule inhibitor shows promise in trastuzumab-resistant metastatic breast cancer
Fox Chase Cancer Center researchers report that a combination of trastuzumab and neratinib (HKI-272) a novel small molecule inhibitor of the HER2 receptor (ErbB2) appears active in women with HER2-positive metastatic breast cancer who have progressed on previous trastuzumab based therapies.
Lithium may help radiation target cancer, spare healthy tissue
Vanderbilt-Ingram Cancer Center investigators have uncovered a mechanism that helps explain how lithium, a drug widely used to treat bipolar mood disorder, also protects the brain from damage that occurs during radiation treatments.
Brain metastases hijack neuron-supporting cells to resist chemotherapy
Cancer that spreads to other organs finds a particularly inviting hideout in the brain, where these metastases are usually far harder to treat than they are in other locations.
Whole brain radiation increases risk of learning and memory problems in cancer patients
Cancer patients who receive stereotactic radiosurgery (SRS) and whole brain radiation therapy (WBRT) for the treatment of metastatic brain tumors have more than twice the risk of developing learning and memory problems than those treated with SRS alone, according to new research from The University of Texas M. D. Anderson Cancer Center.
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