Incidence of brain metastases in patients with early HER2-positive breast cancer receiving neoadjuvant chemotherapy with trastuzumab and pertuzumab

Ferraro, Emanuela, Singh, Jasmeet, Patil, Sujata, Razavi, Pedram, Modi, Shanu, Chandarlapaty, Sarat, Barrio, Andrea V, Malani, Rachna, Mellinghoff, Ingo K, Boire, Adrienne, Wen, Hannah Y, Brogi, Edi, Seidman, Andrew D, Norton, Larry, Robson, Mark E, Dang, Chau T (March 2022) Incidence of brain metastases in patients with early HER2-positive breast cancer receiving neoadjuvant chemotherapy with trastuzumab and pertuzumab. npj Breast Cancer, 8 (1). p. 37. ISSN 2374-4677

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DOI: 10.1038/s41523-022-00380-7


The addition of pertuzumab (P) to trastuzumab (H) and neoadjuvant chemotherapy (NAC) has decreased the risk of distant recurrence in early stage HER2-positive breast cancer. The incidence of brain metastases (BM) in patients who achieved pathological complete response (pCR) versus those who do not is unknown. In this study, we sought the incidence of BM in patients receiving HP-containing NAC as well as survival outcome. We reviewed the medical records of 526 early stage HER2-positive patients treated with an HP-based regimen at Memorial Sloan Kettering Cancer Center (MSKCC), between September 1, 2013 to November 1, 2019. The primary endpoint was to estimate the cumulative incidence of BM in pCR versus non-pCR patients; secondary endpoints included disease free-survival (DFS) and overall survival (OS). After a median follow-up of 3.2 years, 7 out of 286 patients with pCR had a BM while 5 out of 240 non-pCR patients had a BM. The 3-year DFS was significantly higher in the pCR group compared to non-pCR group (95% vs 91 %, p = 0.03) and the same trend was observed for overall survival. In our cohort, despite the better survival outcomes of patients who achieved pCR, we did not observe appreciable differences in the incidence of BM by pCR/non-pCR status. This finding suggests that the BM incidence could not be associated with pCR. Future trials with new small molecules able to cross the blood brain barrier should use more specific biomarkers rather than pCR for patients' selection.

Item Type: Paper
Subjects: organs, tissues, organelles, cell types and functions > organs types and functions > brain
diseases & disorders > cancer > cancer types > breast cancer
diseases & disorders > cancer > drugs and therapies > chemotherapy
diseases & disorders > cancer > metastasis
CSHL Authors:
Communities: CSHL labs > Wigler lab
SWORD Depositor: CSHL Elements
Depositing User: CSHL Elements
Date: 22 March 2022
Date Deposited: 04 Apr 2022 14:41
Last Modified: 04 Apr 2022 14:41

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