Bottosso Michele, Griguolo Gaia, Guiu Severine, Guarascio Maria Cristina, Bailleux Caroline, Miglietta Federica, Cattelan Anna Chiara, Zurlo Christian, Ferrero Jean-Marc, Aldegheri Vittoria, Falci Cristina, Zanghì Francesca, Giorgi Carlo Alberto, Parisi Alessandro, Vernaci Grazia Maria, Girardi Fabio, Jacot William, Dieci Maria Vittoria, Darlix Amélie, Guarneri Valentina
Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, IT, Italy.
Division of Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, IT, Italy.
NPJ Breast Cancer. 2025 Feb 20;11(1):20. doi: 10.1038/s41523-025-00735-w.
Brain metastases (BMs) are a common complication of advanced breast cancer (BC), and their management has significantly evolved. We evaluated the clinical impact of these changes dividing patients diagnosed with BCBMs at three Institutions according to year of BMs diagnosis: 2000-2007 (group A), 2008-2014 (group B) and 2015-2022 (group C). Stereotactic radiotherapy increased (p < 0.001), and WBRT decreased (p = 0.010) over time. Among HER2+ BC patients, more received anti-HER2 therapy after BM diagnosis in recent years (p < 0.011). Overall survival (OS) did not improve in the entire cohort (p = 0.260); however, OS improved in patients with HR-/HER2+ BC (median OS 8.7, 10.1, 23.7 months in group A, B, C, respectively; p = 0.002). HER2-positivity, not prognostic in group A, became prognostic in group C (p < 0.001). While therapy for patients with BCBMs significantly changed over two decades, an OS improvement was observed only in HR-/HER2+ patients, potentially due to increased availability of anti-HER2 therapies with intracranial activity.
脑转移（BMs）是晚期乳腺癌（BC）的常见并发症，其治疗方法有了显著进展。我们根据BMs诊断年份，对在三家机构诊断为BCBMs的患者进行分组，评估这些变化的临床影响：2000 - 2007年（A组）、2008 - 2014年（B组）和2015 - 2022年（C组）。随着时间推移，立体定向放射治疗增加（p < 0.001），而全脑放疗减少（p = 0.010）。在HER2 + BC患者中，近年来BMs诊断后接受抗HER2治疗的患者增多（p < 0.011）。整个队列的总生存期（OS）没有改善（p = 0.260）；然而，HR - /HER2 + BC患者的OS有所改善（A组、B组、C组的中位OS分别为8.7、10.1、23.7个月；p = 0.002）。HER2阳性在A组中无预后意义，在C组中成为预后因素（p < 0.001）。虽然BCBMs患者的治疗在二十年间发生了显著变化，但仅在HR - /HER2 + 患者中观察到OS改善，这可能是由于具有颅内活性的抗HER2治疗药物的可及性增加。
