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


Authors: Ferraro, E.; Singh, J.; Patil, S.; Razavi, P.; Modi, S.; Chandarlapaty, S.; Barrio, A. V.; Malani, R.; Mellinghoff, I. K.; Boire, A.; Wen, H. Y.; Brogi, E.; Seidman, A. D.; Norton, L.; Robson, M. E.; Dang, C. T.
Article Title: Incidence of brain metastases in patients with early HER2-positive breast cancer receiving neoadjuvant chemotherapy with trastuzumab and pertuzumab
Abstract: 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. © 2022, The Author(s).
Journal Title: npj Breast Cancer
Volume: 8
ISSN: 2374-4677
Publisher: Nature Publishing Group  
Date Published: 2022-03-22
Start Page: 37
Language: English
DOI: 10.1038/s41523-022-00380-7
PROVIDER: scopus
PUBMED: 35319017
PMCID: PMC8940915
DOI/URL:
Notes: Article -- Export Date: 1 April 2022 -- Source: Scopus
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MSK Authors
  1. Sujata Patil
    511 Patil
  2. Andrea Veronica Barrio
    134 Barrio
  3. Andrew D Seidman
    318 Seidman
  4. Larry Norton
    758 Norton
  5. Mark E Robson
    676 Robson
  6. Chau Dang
    271 Dang
  7. Hannah Yong Wen
    301 Wen
  8. Shanu Modi
    265 Modi
  9. Edi Brogi
    515 Brogi
  10. Adrienne Boire
    106 Boire
  11. Pedram Razavi
    172 Razavi
  12. Jasmeet Chadha Singh
    23 Singh
  13. Rachna Malani
    38 Malani
  14. Emanuela Ferraro
    31 Ferraro