Journal article
Estrogen/progesterone receptor and HER2 discordance between primary tumor and brain metastases in breast cancer and its effect on treatment and survival
Neuro-oncology (Charlottesville, Va.), Vol.22(9), pp.1359-1367
09/01/2020
DOI: 10.1093/neuonc/noaa025
PMCID: PMC7523450
PMID: 32034917
Abstract
Background. Breast cancer treatment is based on estrogen receptors (ERs), progesterone receptors (PRs), and human epidermal growth factor receptor 2 (HER2). At the time of metastasis, receptor status can be discordant from that at initial diagnosis.The purpose of this study was to determine the incidence of discordance and its effect on survival and subsequent treatment in patients with breast cancer brain metastases (BCBM).
Methods. A retrospective database of 316 patients who underwent craniotomy for BCBM between 2006 and 2017 was created. Discordance was considered present if the ER, PR, or HER2 status differed between the primary tumor and the BCBM.
Results. The overall receptor discordance rate was 132/316 (42%), and the subtype discordance rate was 100/316 (32%). Hormone receptors (HR, either ER or PR) were gained in 40/160 (25%) patients with HR-negative primary tumors. HER2 was gained in 22/173 (13%) patients with HER2-negative primary tumors. Subsequent treatment was not adjusted for most patients who gained receptors-nonetheless, median survival (MS) improved but did not reach statistical significance (HR, 17-28 mo, P= 0.12; HER2, 15-19 mo, P= 0.39). MS for patients who lost receptors was worse (HR, 27-18 mo, P= 0.02; HER2, 30-18 mo, P= 0.08).
Conclusions. Receptor discordance between primary tumor and BCBM is common, adversely affects survival if receptors are lost, and represents a missed opportunity for use of effective treatments if receptors are gained. Receptor analysis of BCBM is indicated when clinically appropriate. Treatment should be adjusted accordingly.
Details
- Title: Subtitle
- Estrogen/progesterone receptor and HER2 discordance between primary tumor and brain metastases in breast cancer and its effect on treatment and survival
- Creators
- Paul W. Sperduto - Minneapolis Radiation Oncology and University of Minnesota Gamma Knife Center, Minneapolis, Minnesota, USA.Shane Mesko - The University of Texas MD Anderson Cancer CenterJing Li - The University of Texas MD Anderson Cancer CenterDaniel Cagney - Dana-Farber Cancer InstituteAyal Aizer - Dana-Farber Cancer InstituteNancy U. Lin - Dana Farber Canc Inst, Boston, MA 02115 USAEric Nesbit - Northwestern UniversityTim J. Kruser - Northwestern UniversityJason Chan - University of California, San FranciscoSteve Braunstein - University of California, San FranciscoJessica Lee - Duke UniversityJohn P. Kirkpatrick - Duke UniversityWill Breen - Mayo Clin, Rochester, MN USAPaul D. Brown - Mayo Clinic,Rochester,Minnesota,USADiana Shi - Massachusetts General HospitalHelen A. Shih - Massachusetts General HospitalHany Soliman - Sunnybrook Health Science CentreArjun Sahgal - Sunnybrook Health Science CentreRyan Shanley - University of MinnesotaWilliam Sperduto - Duke UniversityEmil Lou - University of MinnesotaAshlyn Everett - University of Alabama at BirminghamDrexell Hunter Boggs - University of Alabama at BirminghamLaura Masucci - Centre Hospitalier de l’Université de MontréalDavid Roberge - Centre Hospitalier de l’Université de MontréalJill Remick - University of Maryland, BaltimoreKristin Plichta - University of IowaJohn M. Buatti - University of IowaSupriya Jain - University of Colorado Anschutz Medical CampusLaurie E. Gaspar - University of Colorado DenverCheng-Chia Wu - Columbia UniversityTony J. C. Wang - Columbia UniversityJohn Bryant - Miami Cancer Institute, Miami, Florida, USA.Michael Chuong - Miami Cancer Institute, Miami, Florida, USA.James Yu - Yale UniversityVeronica Chiang - Yale UniversityToshimichi Nakano - University of Niigata, Niigata, Japan.Hidefumi Aoyama - University of Niigata, Niigata, Japan.Minesh P. Mehta - Miami Cancer Institute, Miami, Florida, USA.
- Resource Type
- Journal article
- Publication Details
- Neuro-oncology (Charlottesville, Va.), Vol.22(9), pp.1359-1367
- DOI
- 10.1093/neuonc/noaa025
- PMID
- 32034917
- PMCID
- PMC7523450
- NLM abbreviation
- Neuro Oncol
- ISSN
- 1522-8517
- eISSN
- 1523-5866
- Publisher
- Oxford Univ Press
- Number of pages
- 9
- Grant note
- P30 CA77598 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA NCATS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) UL1TR002494 / National Institutes of Health (NIH) from the National Center for Advancing Translational Sciences (NCATS)
- Language
- English
- Date published
- 09/01/2020
- Academic Unit
- Radiation Oncology; Neurosurgery; Otolaryngology
- Record Identifier
- 9984304031102771
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