Multi-institutional report of trastuzumab deruxtecan and stereotactic radiosurgery for HER2 positive and HER2-low breast cancer brain metastases
Abstrak
Abstract Trastuzumab-deruxtecan (T-DXd) has demonstrated intracranial efficacy; however, safety and efficacy data remains limited with stereotactic radiosurgery (SRS). A multi-institutional review was performed with HER2+ or HER2-low metastatic breast cancer treated with T-DXd and SRS for active brain metastases. We identified 215 lesions treated over 48 SRS courses in 34 patients. Median follow up from T-DXd initiation was 13.9 months. The cumulative incidence of symptomatic radiation necrosis at 24 months per lesion was 2.1% and per patient 11%. The 12-month LC was 97%. HER2-low was associated with worse distant intracranial control (DIC) (adjusted HR 2.5, 95% CI 1.1–5.6, p = 0.03) and worse systemic progression free survival (PFS) (HR 4.1, 95% CI 1.6–10.7, p = 0.004). Concurrent SRS and T-DXd has excellent local control, without an increased risk of radiation necrosis. HER2-low disease is associated with worse systemic PFS and DIC with T-DXd compared to HER2+.
Topik & Kata Kunci
Penulis (23)
Vaseem M. Khatri
Mariella A. Mestres-Villanueva
Sreenija Yarlagadda
Ajay Doniparthi
David B. Smith
Justyn Y. Nakashima
John M. Bryant
Dekuang Zhao
Rituraj Upadhyay
Matthew N. Mills
Daniel E. Oliver
Hsiang-Hsuan Michael Yu
Joshua D. Palmer
Nicole O. Williams
Reshma L. Mahtani
Manmeet S. Ahluwalia
Hatem H. Soliman
Hyo S. Han
Aixa E. Soyano
Youngchul Kim
Rupesh Kotecha
Sasha J. Beyer
Kamran A. Ahmed
Format Sitasi
Akses Cepat
- Tahun Terbit
- 2024
- Sumber Database
- DOAJ
- DOI
- 10.1038/s41523-024-00711-w
- Akses
- Open Access ✓