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International Journal of Clinical Oncology

, Volume 14, Issue 1, pp 48–52 | Cite as

Brain metastases in patients who receive trastuzumab-containing chemotherapy for HER2-overexpressing metastatic breast cancer

  • Makiko Ono
  • Masashi AndoEmail author
  • Mayu Yunokawa
  • Eriko Nakano
  • Kan Yonemori
  • Koji Matsumoto
  • Tsutomu Kouno
  • Chikako Shimizu
  • Kenji Tamura
  • Noriyuki Katsumata
  • Yasuhiro Fujiwara
Original Article

Abstract

Background

Recently, a high rate of brain metastases has been reported among patients with human epidermal growth factor receptor (HER2)-overexpressing metastatic breast cancer who were treated with trastuzumab. The present study examined risk factors for the development of brain metastasis in patients with HER2-overexpressing breast cancer who were treated with trastuzumab.

Methods

We retrospectively reviewed 204 patients with HER-2-overexpressing breast cancer who were treated with a trastuzumab-containing regimen between 1999 and 2006. Patients with clinical symptoms were diagnosed as having brain metastases when brain magnetic resonance imaging (MRI) or a computed tomography (CT) scan revealed positive findings for brain metastases. The median follow-up time of this cohort was 53.6 months.

Results

Among the patients who received a trastuzumabcontaining regimen, 74 patients (36.3%) developed brain metastases. The median survival from the diagnosis of brain metastases was 13.5 months (95% confidence interval [CI], 12.2–14.7 months). The median time interval between the beginning of trastuzumab treatment and the diagnosis of brain metastases was 13.6 months (range, 0.0–45.8 months). Among patients with brain metastases, the median overall survival period was 39 months. A multivariate logistic regression analysis showed that age (≤50 years), recurrent breast cancer, and liver metastases were significant risk factors for the development of brain metastases.

Conclusion

Patients with HER2-overexpressing breast cancer treated with trastuzumab had a high incidence of brain metastases (36.3%). Routine screening for brain metastases 1 year after the start of trastuzumab treatment, may be warranted in younger patients (≤50 years) who had recurrent breast cancer with liver metastases.

Key words

HER2-overexpressing breast cancer Trastuzumab Brain metastases 

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Copyright information

© Japan Society of Clinical Oncology 2009

Authors and Affiliations

  • Makiko Ono
    • 1
  • Masashi Ando
    • 1
    Email author
  • Mayu Yunokawa
    • 1
  • Eriko Nakano
    • 1
  • Kan Yonemori
    • 1
  • Koji Matsumoto
    • 2
  • Tsutomu Kouno
    • 1
  • Chikako Shimizu
    • 1
  • Kenji Tamura
    • 1
  • Noriyuki Katsumata
    • 1
  • Yasuhiro Fujiwara
    • 1
  1. 1.Breast and Medical Oncology DivisionNational Cancer Center HospitalTokyoJapan
  2. 2.Medical Oncology DivisionHyogo Cancer CenterHyogoJapan

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