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Cancers
Special Issues
Breast Cancer Brain Metastasis and Leptomeningeal Disease
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Breast Cancer Brain Metastasis and Leptomeningeal Disease

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Metastasis".

Deadline for manuscript submissions: 15 September 2024 | Viewed by 1844

Special Issue Editors

Dr. Albert Grinshpun

E-Mail Website
Guest Editor
Dana-Farber Cancer Institute, Boston, MA, USA
Interests: metastatic breast cancer; molecular medicine; brain metastasis
Dr. Sarah Sammons

E-Mail Website
Guest Editor
Dana-Farber Cancer Institute, Boston, MA, USA
Interests: metastatic breast cancer; brain metastases
Dr. Nancy U. Lin

E-Mail Website
Guest Editor
1. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
2. Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
3. Harvard Medical School, Boston, MA, USA
Interests: metastatic breast cancer; brain metastases

Special Issue Information

Dear Colleagues,

Brain metastases are the most common intracranial malignancy. About one in five patients with metastatic breast cancer will develop brain metastases (BMs) during their disease course. Specifically, HER2-positive and triple-negative breast cancer subtypes have higher incidences of BMs, with recent data suggesting an increase in the overall incidence of MBC-related BMs in Western countries. Historically, BMs were associated with poor prognoses; however, novel approaches and therapies are starting to change the paradigm in patients with MBC-related BMs. Furthermore, BMs from metastatic breast cancer were found to have unique clinical and molecular features when compared to other tumor types, highlighting the need for further specific investment and research in this field.

Our goal in the current Special Issue of Cancers is to shed light on the latest advancements in this perplexing field and raise awareness of the most significant contemporary challenges in the diagnosis, monitoring, treatment, and prognostication of patients with metastatic breast cancer and BMs.

Dr. Albert Grinshpun
Dr. Sarah Sammons
Dr. Nancy U. Lin
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • metastatic breast cancer
  • brain metastasis
  • leptomeninageal disease
  • diagnosis
  • monitoring
  • treatment

Published Papers (1 paper)

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Research

17 pages, 1126 KiB  
Article
Stereotactic Radiosurgery for Women Older than 65 with Breast Cancer Brain Metastases
by Rituraj Upadhyay, Brett G. Klamer, Haley K. Perlow, Julia R. White, Jose G. Bazan, Sachin R. Jhawar, Dukagjin M. Blakaj, John C. Grecula, Andrea Arnett, Mariella A. Mestres-Villanueva, Erin H. Healy, Evan M. Thomas, Arnab Chakravarti, Raju R. Raval, Maryam Lustberg, Nicole O. Williams, Joshua D. Palmer and Sasha J. Beyer
Cancers 2024, 16(1), 137; https://doi.org/10.3390/cancers16010137 - 27 Dec 2023
Cited by 1 | Viewed by 1016
Abstract
Background: Breast cancer is the second most common cause of brain metastases (BM). Despite increasing incidence of BM in older women, there are limited data on the optimal management of BM in this age group. In this study, we assessed the survival outcomes [...] Read more.
Background: Breast cancer is the second most common cause of brain metastases (BM). Despite increasing incidence of BM in older women, there are limited data on the optimal management of BM in this age group. In this study, we assessed the survival outcomes and treatment patterns of older breast cancer patients ≥65 years old with BM compared to younger patients at our institution. Methods: An IRB-approved single-institutional retrospective review of biopsy-proven breast cancer patients with BM treated with 1- to 5-fraction stereotactic radiation therapy (SRS) from 2015 to 2020 was performed. Primary endpoint was intracranial progression-free survival (PFS) defined as the time interval between the end of SRS to the date of the first CNS progression. Secondary endpoints were overall survival (OS) from the end of SRS and radiation treatment patterns. Kaplan–Meier estimates and Cox proportional hazard regression method were used for survival analyses. Results: A total of 112 metastatic breast cancer patients with BMs were included of which 24 were ≥65 years old and 88 were <65 years old. Median age at RT was 72 years (range 65–84) compared to 52 years (31–64) in younger patients. There were significantly higher number of older women with ER/PR positive disease (75% vs. 49%, p = 0.036), while younger patients were more frequently triple negative (32% vs. 12%, p = 0.074) and HER2 positive (42% vs. 29%, p = 0.3). Treatment-related adverse events were similar in both groups. Overall, 14.3% patients had any grade radiation necrosis (RN) (older vs. young: 8.3% vs. 16%, p = 0.5) while 5.4% had grade 3 or higher RN (0% vs. 6.8%, p = 0.7). Median OS after RT was poorer in older patients compared to younger patients (9.5 months vs. 14.5 months, p = 0.037), while intracranial PFS from RT was similar between the two groups (9.7 months vs. 7.1 months, p = 0.580). On univariate analysis, significant predictors of OS were age ≥65 years old (hazard risk, HR = 1.70, p = 0.048), KPS ≤ 80 (HR = 2.24, p < 0.001), HER2 positive disease (HR = 0.46, p < 0.001), isolated CNS metastatic disease (HR = 0.29, p < 0.001), number of brain metastases treated with RT (HR = 1.06, p = 0.028), and fractionated SRS (HR = 0.53, p = 0.013). On multivariable analysis, KPS ≤ 80, HER2 negativity and higher number of brain metastases predicted for poorer survival, while age was not a significant factor for OS after adjusting for other variables. Patients who received systemic therapy after SRS had a significantly improved OS on univariate and multivariable analysis (HR = 0.32, p < 0.001). Number of brain metastases treated was the only factor predictive of worse PFS (HR = 1.06, p = 0.041), which implies a 6% additive risk of progression for every additional metastasis treated. Conclusions: Although older women had poorer OS than younger women, OS was similar after adjusting for KPS, extracranial progression, and systemic therapy; and there was no difference in rates of intracranial PFS, neurological deaths, and LMD in the different age groups. This study suggests that age alone may not play an independent role in treatment-selection and that outcomes for breast cancer patients with BMs and personalized decision-making including other clinical factors should be considered. Future studies are warranted to assess neurocognitive outcomes and other radiation treatment toxicities in older patients. Full article
(This article belongs to the Special Issue Breast Cancer Brain Metastasis and Leptomeningeal Disease)
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