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Tumor subtype predicted survival after WBRT for metastatic breast cancer

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SAN FRANCISCO — Tumor subtype predicted survival among patients with breast cancer who underwent whole-brain radiation therapy for brain metastases, according to study results presented at the Breast Cancer Symposium.

However, survival was not associated with tumor subtype among patients treated with stereotactic radiosurgery, results showed.

Vipin Das Villgran, MD, medical resident at University of Pittsburgh Medical Center, and colleagues evaluated data from 193 patients with breast cancer who underwent whole-brain radiation therapy (WBRT; n=131) or stereotactic radiosurgery (n=62) for brain metastases between 1997 and 2013.

Forty-five percent of patients who received stereotactic radiosurgery had hormone receptor-positive, HER-2–negative disease. Researchers noted the distribution of tumor subtypes was comparable between the treatment cohorts.

Patients who underwent stereotactic radiosurgery demonstrated significantly longer median OS than those in the WBRT cohort (15 months vs. 10 months; P=.03).

Survival outcomes differed significantly among patients who received WBRT according to tumor subtype. OS was highest among patients with HER-2–positive, HR–negative disease (30 months; 95% CI, 13-37); followed by 14 months (95% CI, 5-24) among those with HER-2–positive, HR–positive disease; 8 months (95% CI, 4-11) among those with HER-2–negative, HR–positive disease; and 5 months (95% CI, 3-9) among those with triple-negative disease (P=.0003).

However, survival was comparable among patients with different tumor subtypes who underwent stereotactic radiosurgery. Median OS was 11 months (95% CI, 5-27) among those with HER-2–positive, HR–negative disease; 25 months (95% CI, 7-32) among those with HER-2–positive, HR–positive disease; 18 months (95% CI, 14-32) among those with HER-2–negative, HR–positive disease; and 12 months (95% CI, 3-24) among those with triple-negative disease (P=.07).

“The main highlight of the results are that the HER-2–positive, HR–negative patients did better with WBRT compared with stereotactic radiosurgery,” Villgran told HemOnc Today. “We need to consider other treatment possibilities that can cross the blood–brain barrier and improve survival in these patients.”

For more information:

Villgran VD. Abstract #74. Presented at: Breast Cancer Symposium; Sept. 4-6, 2014; San Francisco.

Disclosures: The researchers report no relevant financial disclosures.