Long-term survival of breast cancer patients with brain metastases: subanalysis of the BMBC Registry

Up to 30% of metastatic breast cancer (BC) patients develop brain metastases (BM). Long-term survival (LTS) in these patients is rare. Identification of factors associated with LTS is important for treatment improvements.

2889 patients of the BMBC-registry were available for this analysis. 887 patients were categorized as LTS (overall survival >15 months).

LTS were younger at BC and BM diagnosis (median 48 vs 54 years, 53 vs 59 years), more often HER2+ (59.1% vs 36.3%), less luminal-like (29.1% vs 35.7%) or TNBC (11.9% vs 28.1%), showed better ECOG (ECOG 0-1 76.9% vs 51.0%), higher pCR rate (21.6% vs 13.7%) and lower number of BM (n=1 40.9% vs 25.4%; n=2-3: 26.5% vs 26.7%; n≥4: 32.6% vs 47.9%) (p<0.001). Median OS in LTS was 30.9 months (95% CI 28.8-32.6) overall, 33.9 (95% CI 31.5-37.9) in HER2+, 26.9 (95% CI 25.0-30.9) in luminal-like, 26.5 (95% CI 22.7-31.2) in TNBC patients. Multivariate analysis (p<0.001) showed following significantly LTS factors: age (≥60 vs. <60 years: odds ratio (OR) 0.59, 95% CI 0.44-0.79), ECOG (2-4 vs 0-1: OR 0.45, 95% CI 0.33-0.61), HR+ (HR+ vs HR-: OR=1.87, 95%CI 1.39-2.50), HER2+ (HER2+ vs HER2-: OR 2.74, 95%CI 2.06-3.64), BM number (≥4 vs 1: OR 0.46, 95% CI 0.33-0.65, p<0.001), chemotherapy after (yes vs. no: OR 2.19, 95% CI 1.64-2.92) and no ECM at BM diagnosis (yes vs no, OR 0.65, 95% CI 0.46-0.93, p=0.02).

Our analysis identified factors associated with LTS of BM BC patients. LTS might be more eligible for extended treatments.

Publication History

Article published online:
21 June 2022