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. 2020 Dec;16(2):110-118.
doi: 10.14216/kjco.20017. Epub 2020 Dec 31.

The current status of cancer survivorship care and a consideration of appropriate care model in Korea

Hye Mi Ko  1 , Je-Ryong Kim  1 , Jin Sun Lee  1
Affiliations

The current status of cancer survivorship care and a consideration of appropriate care model in Korea

Hye Mi Ko et al. Korean J Clin Oncol. 2020 Dec.

Abstract

Purpose: Breast cancer patients with a human epidermal growth factor receptor 2 (HER2) enriched subtype are known to have higher rates of brain metastases (BM) than other patients. This study aimed to evaluate treatment options and survival outcomes.

Methods: A total of 115 breast cancer brain metastases (BCBM) patients with nearly complete medical records were retrospectively analyzed. Additionally, 36 patients were HER2 enriched types according to histological subtypes. The BM was found by brain magnetic resonance imaging in patients who had neurologic symptoms or by regular screening. Age, breast tumor size, number of BM, histological subtypes, first treatment of breast cancer, estrogen receptor, and HER2 status, stage, local treatment of BM were analyzed. Median overall survival, 5-year survival were analyzed from the data.

Results: The median survival time after BM was 6 months, the mean survival time was 16.3 months, and the 5-year survival after BM was only 8.0%. Factors that significantly affect the survival of BCBM patients include histological subtype, number of BM, use of lapatinib in multivariate analysis. A total of 19 out of 36 HER2 enriched patients were treated with lapatinib or capecitabine. For the treatment of HER2 enriched patients, additional use of blood-brain barrier (BBB) crossing substances, as well as local treatment for BM, significantly improve the survival rate in the Kaplan-Meier method (P=0.001).

Conclusion: A combination of local treatment modality for BCBM and the use of substances that cross the BBB for the HER2 enriched patient improved the survival rate.

Keywords: Blood-brain barrier; Brain neoplasms; Breast neoplasms.

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Conflict of interest statement

CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Five-year survival rate after brain metastases (BM) according to local treatment modality of BM. MTX, methotrexate; WBRT, whole brain radiotherapy; GKS, Gamma Knife surgery; Tx, treatment.
Fig. 2
Fig. 2
Five-year survival rate after brain metastases (BM) with human epidermal growth factor receptor 2 enriched breast cancer patients according to (A) use of lapatinib or capecitabine (P=0.001), (B) local treatment modality (P<0.001), (C) local treatment modality of BM and capecitabine (P<0.001). Tx, treatment; WBRT, whole brain radiotherapy; GKS, Gamma Knife surgery.
See this image and copyright information in PMC

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