Chemo, Trastuzumab, Surgery Up Survival in HER2-Positive MBC

After adjustment, only chemo, trastuzumab linked to survival for patients with CNS metastases

MONDAY, July 18 (HealthDay News) -- Patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) and central nervous system (CNS) metastases have improved survival with trastuzumab, chemotherapy, and surgical treatment, according to a study published in the July 15 issue of Clinical Cancer Research.

Adam M. Brufsky, M.D., Ph.D., from the University of Pittsburgh Cancer Center, and colleagues compared baseline characteristics of patients with and without CNS metastases in 1,012 patients enrolled in registHER with newly diagnosed, confirmed, HER2-positive MBC. The incidence, time to development, treatment, and survival after CNS metastases were investigated. The correlation between different treatments and survival was assessed.

The investigators found that 37.3 percent (377) of the patients had CNS metastases. The patients with CNS metastases were younger than those without and were more likely to have hormone receptor negative disease and a higher disease burden. For patients without CNS disease at the initial diagnosis, the median time to CNS progression was 13.3 months. A significant improvement in median overall survival was seen for treatment with trastuzumab (17.5 months, versus 3.8 months without), chemotherapy (16.4 months, versus 3.7 without), and surgery (20.3 months, versus 11.3 months without). Median survival was prolonged with radiotherapy but not significantly (13.9 months, versus 8.4 months without; P = 0.134). Independent significant effects of trastuzumab and chemotherapy treatments were confirmed by multivariable proportional hazards analyses (hazard ratio, 0.33 and 0.64, respectively).

"For patients with HER2-positive MBC evaluated in registHER, the use of trastuzumab, chemotherapy, and surgery following CNS metastases were each associated with longer survival," the authors write.

Several authors disclosed financial ties with Genentech, which also funded the study.

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