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Ge H, Zhu K, Sun Q, Wang H, Liu H, Ge J, Liu C, Liang P, Lv Z, Bao H. The clinical, molecular, and therapeutic implications of time from primary diagnosis to brain metastasis in lung and breast cancer patients. Cancer Med 2024; 13:e7364. [PMID: 38847084 PMCID: PMC11157198 DOI: 10.1002/cam4.7364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/13/2024] [Accepted: 05/27/2024] [Indexed: 06/10/2024] Open
Abstract
PURPOSE Lung cancer (LC) and breast cancer (BC) are the most common causes of brain metastases (BMs). Time from primary diagnosis to BM (TPDBM) refers to the time interval between initial LC or BC diagnosis and development of BM. This research aims to identify clinical, molecular, and therapeutic risk factors associated with shorter TPDBM. METHODS We retrospectively reviewed all diagnosed LC and BC patients with BM at Harbin Medical University Cancer Hospital from 2016 to 2020. A total of 570 patients with LC brain metastasis (LCBM) and 173 patients with breast cancer brain metastasis (BCBM) patients who met the inclusion criteria were enrolled for further analysis. BM free survival time curves were generated using Kaplan-Meier analyses. Univariate and multivariate Cox regression analyses were applied to identify risk factors associated with earlier development of BM in LC and BC, respectively. RESULTS The median TPDBM was 5.3 months in LC and 44.4 months in BC. In multivariate analysis, clinical stage IV and M1 stage were independent risk factors for early development of LCBM. LC patients who received chemotherapy, targeted therapy, pulmonary radiotherapy, and pulmonary surgery had longer TPDBM. For BC patients, age ≥ 50 years, Ki67 ≥ 0.3, HER2 positive or triple-negative breast cancer subtype, advanced N stage, and no mastectomy were correlated with shorter TPDBM. CONCLUSIONS This single-institutional study helps identify patients who have a high risk of developing BM early. For these patients, early detection and intervention could have clinical benefits.
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Affiliation(s)
- Haitao Ge
- Department of NeurosurgeryThe First Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Kaibin Zhu
- Department of Thoracic SurgeryHarbin Medical University Cancer HospitalHarbinChina
| | - Qian Sun
- Department of NeurosurgeryHarbin Medical University Cancer HospitalHarbinChina
| | - Huan Wang
- Department of NeurosurgeryHarbin Medical University Cancer HospitalHarbinChina
| | - Hui Liu
- Department of NeurosurgeryHarbin Medical University Cancer HospitalHarbinChina
| | - Jinyi Ge
- Harbin Medical UniversityHarbinChina
| | - Chunyang Liu
- Department of NeurosurgeryThe First Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Peng Liang
- Department of NeurosurgeryHarbin Medical University Cancer HospitalHarbinChina
| | - Zhonghua Lv
- Department of NeurosurgeryHarbin Medical University Cancer HospitalHarbinChina
| | - Hongbo Bao
- Department of NeurosurgeryHarbin Medical University Cancer HospitalHarbinChina
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
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Nobbe K, Erices-Leclercq M, Foerster F, Förster R, Baldus SE, Rudlowski C, Schröder L, Lubig S. HER2 Low Expression in Primary Male Breast Cancer. BREAST CANCER (DOVE MEDICAL PRESS) 2024; 16:141-148. [PMID: 38562651 PMCID: PMC10984208 DOI: 10.2147/bctt.s450682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024]
Abstract
Purpose The introduction of HER2-targeting antibody drug conjugates (ADCs) offers new treatment options for female breast cancer patients (FBC) expressing low levels of HER2 (HER2 low). No evidence was found that HER2 low describes a new FBC subtype. There is a lack of studies determining the impact of HER2 low in male breast cancer (MBC). In this study, we evaluate the prevalence of HER2 low in primary MBC and correlate the results with patient characteristics. Patients and Methods In this study, histological specimens were obtained from 120 male patients diagnosed and treated for primary invasive breast cancer from 1995 to 2022 at Breast Cancer Units in Bergisch Gladbach, Chemnitz, and Zwickau, Germany. HER2 immunostaining and in situ hybridization were performed by central pathology and evaluated based on the ASCO/CAP guidelines. The correlation of expression of HER2 low with tumor biological characteristics and patient outcomes was investigated. Results Out of all cases, four patients (3.3%) showed HER2 positivity (3+), 39 (32.5%) patients were classified as HER2 low, 7 (5.8%) were HER2 2+ (no amplification), 32 (26.7%) were HER2 1+, and 77 (64.2%) were classified as HER2 zero. Out of 77 HER2 zero cases, 47 tumors (61.0%) showed incomplete staining, with <10% of tumor cells classified as HER2 ultralow. No statistical correlation between HER2 low and tumor biological characteristics and patients' survival was found. Conclusion Our findings show a notable, albeit lower, prevalence of HER2 low expression in primary MBC. However, tumors expressing HER2 low do not show specific tumor biological features to define a new breast cancer subtype in MBC. Our results suggest that a significant number of MBC patients could benefit from ADCs, as shown in FBC. Further studies are required to better understand HER2 low breast cancer, both generally and in MBC.
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Affiliation(s)
- Katleen Nobbe
- Breast Unit, Lutheran Hospital Bergisch Gladbach, Bergisch Gladbach, Germany
| | | | - Frank Foerster
- Department of Economical Sciences, University of Applied Sciences, Zwickau, Germany
- Outpatient Department of Gynaecological Oncology and Palliative Care, Chemnitz, Germany
| | - Robert Förster
- Institute for Radiation Oncology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Stephan E Baldus
- Institute for Pathology, Cytology and Molecular Pathology, Bergisch Gladbach, Germany
| | - Christian Rudlowski
- Breast Unit, Lutheran Hospital Bergisch Gladbach, Bergisch Gladbach, Germany
- Department of Gynecology, University Hospital Bonn, Bonn, Germany
| | - Lars Schröder
- Department of Gynaecology and Obstetrics, Ketteler Krankenhaus, Offenbach, Germany
| | - Sabine Lubig
- Breast Unit, Lutheran Hospital Bergisch Gladbach, Bergisch Gladbach, Germany
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Paluch-Shimon S, Cardoso F, Partridge AH, Abulkhair O, Azim HA, Bianchi-Micheli G, Cardoso MJ, Curigliano G, Gelmon KA, Gentilini O, Harbeck N, Kaufman B, Kim SB, Liu Q, Merschdorf J, Poortmans P, Pruneri G, Senkus E, Sirohi B, Spanic T, Sulosaari V, Peccatori F, Pagani O. ESO-ESMO fifth international consensus guidelines for breast cancer in young women (BCY5). Ann Oncol 2022; 33:1097-1118. [PMID: 35934170 DOI: 10.1016/j.annonc.2022.07.007] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/14/2022] [Accepted: 07/17/2022] [Indexed: 12/31/2022] Open
Abstract
We dedicate this manuscript in memory of a dear friend and colleague Bella Kaufman. The fifth International Consensus Symposium for Breast Cancer in Young Women (BCY5) took place virtually in October 2020, organized by the European School of Oncology (ESO) and the European Society of Medical Oncology (ESMO). Consensus recommendations for the management of breast cancer in young women were updated from BCY4 with incorporation of new evidence to inform the guidelines. Areas of research priorities as well as specificities in different geographic and minority populations were identified. This manuscript summarizes the ESO-ESMO international consensus recommendations, which are also endorsed by the European Society of Breast Specialists (EUSOMA).
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Affiliation(s)
- S Paluch-Shimon
- Hadassah University Hospital & Faculty of Medicine, Hebrew University, Jerusalem, Israel.
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal
| | | | - O Abulkhair
- King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia
| | - H A Azim
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | | | - M J Cardoso
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal
| | - G Curigliano
- European Institute of Oncology IRCCS, Milan; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - K A Gelmon
- British Columbia Cancer, Vancouver, Canada
| | | | - N Harbeck
- Breast Center, Department of OB&GYN and CCCMunich, LMU University Hospital, Munich, Germany
| | - B Kaufman
- Sheba Medical Center, Ramat Gan, Israel
| | - S B Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Q Liu
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | | | - P Poortmans
- Iridium Netwerk, Department of Radiation Oncology & University of Antwerp, Faculty of Medicine and Health Sciences, Wilrijk-Antwerp, Belgium
| | - G Pruneri
- National Cancer Institute, IRCCS Foundation, Milan, Italy
| | - E Senkus
- Medical University of Gdansk, Gdansk, Poland
| | - B Sirohi
- Max Institute of Cancer Care, New Delhi and Gurgaon, India
| | - T Spanic
- Europa Donna Slovenia, Ljubljana, Slovenia
| | - V Sulosaari
- European Oncology Nursing Society (EONS) and Turku University of Applied Sciences, Turku, Finland
| | - F Peccatori
- European Institute of Oncology IRCCS, Milan; European Institute of Oncology IRCCS & European School of Oncology, Milan, Italy
| | - O Pagani
- Interdisciplinary Cancer Service Hospital Riviera-Chablais Rennaz, Vaud, Geneva University Hospitals, Lugano University, Swiss Group for Clinical Cancer Research (SAKK), Lugano, Switzerland
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