Breast cancer patients treated with intrathecal therapy for leptomeningeal metastases in a large real-life database
作者：Marcela Carausu, Matthieu Carton, Amélie Darlix, Dominique Pasquier, Marianne Leheurteur, M. Debled, Marie‐Ange Mouret‐Reynier, Anthony Gonçalvès, Florence Dalenc, Benjamin Verret, Mario Campone, Paule Augereau, Jean-Marc Ferrero, Christelle Lévy, Jean-David Fumet, Claudia Lefeuvre‐Plesse, Thierry Petit, L. Uwer, Christelle Jouannaud, Louis Larrouquère, M. Chevrot, Coralie Courtinard, Luc Cabel · 发表于：ESMO Open · 年份：2021 · DOI：10.1016/j.esmoop.2021.100150 · 被引用次数：48 · 研究领域：Brain Metastases and Treatment、Cancer Treatment and Pharmacology、Management of metastatic bone disease
BACKGROUND: Leptomeningeal metastasis (LM) is a rare complication of metastatic breast cancer (MBC), with high morbidity/mortality rates. Our study aimed to describe the largest-to-date real-life population of MBC patients treated with intrathecal (IT) therapy and to evaluate prognostic models. METHODS: The Epidemiological Strategy and Medical Economics (ESME) MBC database (NCT03275311) includes all consecutive patients who have initiated treatment for MBC since 2008. Overall survival (OS) of patients treated with IT therapy was estimated using the Kaplan-Meier method. Prognostic models were constructed using Cox proportional hazards models. Performance was evaluated using C-index and calibration plots. RESULTS: Of the 22 266 patients included in the database between 2008 and 2016, 312 received IT therapy and were selected for our analysis. Compared with non-IT-treated patients, IT-treated patients were younger at MBC relapse (median age: 52 years versus 61 years) and more often had lobular histology (23.4% versus 12.7%) or triple-negative subtype (24.7% versus 13.3%) (all P < 0.001). Median OS was 4.5 months [95% confidence interval (CI) 3.8-5.6] and 1-year survival rate was 25.6%. Significant prognostic factors associated with poorer outcome on multivariable analysis were triple-negative subtype (hazard ratio 1.81, 95% CI 1.32-2.47), treatment line ≥3 (hazard ratio 1.88, 95% CI 1.30-2.73), ≥3 other metastatic sites (hazard ratio 1.33, 95% CI 1.01-1.74) and IT cytarabine or ...