Subtype switching in breast cancer brain metastases: a multicenter analysis
| العنوان: | Subtype switching in breast cancer brain metastases: a multicenter analysis |
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| المؤلفون: | Priscilla K. Brastianos, Melissa E. Hughes, Alexander F. C. Hulsbergen, Joost J.C. Verhoeff, Timothy R. Smith, Vasileios K. Kavouridis, An Claes, Marike L. D. Broekman, Ali Ansaripour, Nan Lin, Claudine O. Nogarede |
| المصدر: | Neuro-Oncology Neuro-Oncology, 22(8), 1173-1181. OXFORD UNIV PRESS INC Neuro Oncol |
| بيانات النشر: | Oxford University Press (OUP), 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | 0301 basic medicine, Oncology, Cancer Research, medicine.medical_specialty, Receptor, ErbB-2, medicine.drug_class, Receptor expression, Clinical Investigations, Breast Neoplasms, subtype, Surgical pathology, 03 medical and health sciences, breast cancer, 0302 clinical medicine, Breast cancer, brain metastases, Internal medicine, Biopsy, Biomarkers, Tumor, medicine, AcademicSubjects/MED00300, Humans, Neoplasm Metastasis, Retrospective Studies, medicine.diagnostic_test, Brain Neoplasms, business.industry, Incidence (epidemiology), Hazard ratio, Editorials, Middle Aged, Prognosis, medicine.disease, Primary tumor, 030104 developmental biology, Estrogen, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Female, AcademicSubjects/MED00310, Neurology (clinical), receptor discordance, business |
| الوصف: | BackgroundBreast cancer (BC) brain metastases (BM) can have discordant hormonal or human epidermal growth factor receptor 2 (HER2) expression compared with corresponding primary tumors. This study aimed to describe incidence, predictors, and survival outcomes of discordant receptors and associated subtype switching in BM.MethodsBCBM patients seen at 4 tertiary institutions who had undergone BM resection or biopsy were included. Surgical pathology reports were retrospectively assessed to determine discordance between the primary tumor and the BCBM. In discordant cases, expression in extracranial metastases was also assessed.ResultsIn BM from 219 patients, prevalence of any discordance was 36.3%; receptor-specific discordance was 16.7% for estrogen, 25.2% for progesterone, and 10.4% for HER2. Because estrogen and progesterone were considered together for hormonal status, 50 (22.8%) patients switched subtype as a result; 20 of these switches were HER2 based. Baseline subtype predicted switching, which occurred in up to 37.5% of primary HR+ patients. Moreover, 14.8% of initially HER2-negative patients gained HER2 in the BM. Most (63.6%) discordant patients with extracranial metastases also had discordance between BM and extracranial subtype. Loss of receptor expression was generally associated with worse survival, which appeared to be driven by estrogen loss (hazard ratio = 1.80, P = 0.03). Patients gaining HER2 status (n = 8) showed a nonsignificant tendency toward improved survival (hazard ratio = 0.64, P = 0.17).ConclusionsIn this multicenter study, we report incidence and predictors of subtype switching, the risk of which varies considerably by baseline subtype. Switches can have clinical implications for prognosis and treatment choice. |
| وصف الملف: | application/pdf |
| تدمد: | 1523-5866 1522-8517 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dd28f7d220f54f7e6dfa1316ef2ed9c2Test https://doi.org/10.1093/neuonc/noaa013Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....dd28f7d220f54f7e6dfa1316ef2ed9c2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15235866 15228517 |
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