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Is risk of central nervous system (CNS) relapse related to adjuvant taxane treatment in node-positive breast cancer? Results of the CNS substudy in the intergroup phase III BIG 02-98 trial

Pestalozzi, B. C. ; Francis, P. ; Quinaux, E. ; Dolci, S. ; Azambuja, E. ; Gelber, R. D. ; Viale, G. ; Balil, A. ; Andersson, M. ; Nordenskjöld, B. ; Gnant, M. ; Gutierrez, J. ; Láng, I. ; Crown, J. P. A. ; Piccart-Gebhart, M.

In: Annals of Oncology, 2008, vol. 19, no. 11, p. 1837-1841

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    Titre
    • Is risk of central nervous system (CNS) relapse related to adjuvant taxane treatment in node-positive breast cancer? Results of the CNS substudy in the intergroup phase III BIG 02-98 trial
    Auteur
    • Pestalozzi, B. C.. Department of Oncology, University Hospital, Zurich, Switzerland and International Breast Cancer Study Group (IBCSG) and Swiss Group for Clinical Cancer Research
    • Francis, P.. Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia, IBCSG and Australian New Zealand Breast Cancer Trials Group
    • Quinaux, E.. Department of Pathology, International Drug Development Institute, Ottignies Louvain-la-Neuve
    • Dolci, S.. Department of Oncology, Jules Bordet Institute, Brussels, Belgium, and Breast European Adjuvant Studies Team
    • Azambuja, E.. Department of Oncology, Jules Bordet Institute, Brussels, Belgium, and Breast European Adjuvant Studies Team
    • Gelber, R. D.. Department of Biostatistical Science, IBCSG Statistical Center, Dana-Farber Cancer Institute, Boston, USA
    • Viale, G.. Department of Pathology, European Institute of Oncology and University of Milan, Milan, Italy
    • Balil, A.. Department of Oncology, Hospital Universitar Arnau de Vilanova, Spain and Grupo Español de Investigación de Cáncer de Mama
    • Andersson, M.. Department of Oncology, Rigshospitalet, Copenhagen, Denmark and Danish Breast Cancer Group
    • Nordenskjöld, B.. Department of Oncology, University Hospital, Linkoping, Sweden and Scandinavian Breast Cancer Group
    • Gnant, M.. 1st Department of Surgery, Vienna Medical University, Vienna, Austria and Austrian Breast & Colorectal Cancer Study Group
    • Gutierrez, J.. Department of Haematology and Oncology, Clinica Las Condes, Santiago, Chile and Grupo Oncológico Cooperativo Chileno de Investigación
    • Láng, I.. Department of Medical Oncology, National Institute of Oncology, Budapest, Hungary
    • Crown, J. P. A.. Department of Oncology, St Vincent's Hospital, Dublin, Ireland and Irish Clinical Oncology Research Group
    • Piccart-Gebhart, M.. Department of Medicine, Breast International Group, Coordinating Office at the Institut Jules Bordet, Brussels, Belgium
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Annals of Oncology, 2008, vol. 19, no. 11, p. 1837-1841. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:299510
    Summary
    Background: Breast cancer central nervous system (CNS) metastases are an increasingly important problem because of high CNS relapse rates in patients treated with trastuzumab and/or taxanes. Patients and methods: We evaluated data from 2887 node-positive breast cancer patients randomised in the BIG 02-98 trial comparing anthracycline-based adjuvant chemotherapy (control arms) to anthracycline-docetaxel-based sequential or concurrent chemotherapy (experimental arms). After a median follow-up of 5 years, 403 patients had died and detailed information on CNS relapse was collected for these patients. Results: CNS relapse occurred in 4.0% of control patients and 3.7% of docetaxel-treated patients. CNS relapse occurred in 27% of deceased patients in both treatment groups. CNS relapse was usually accompanied by neurologic symptoms (90%), and 25% of patients with CNS relapse died without evidence of extra-CNS relapse. Only 20% of patients survived 1 year from the diagnosis of CNS relapse. Prognosis of CNS relapse was worse for patients with meningeal carcinomatosis when compared with brain metastases. Unexpected findings included a higher rate of positive cerebrospinal fluid cytology (8% versus 3%) and more frequent use of magnetic resonance imaging for diagnosis (47% versus 30%) in the docetaxel-treated patients. Conclusion: There is no evidence that adjuvant docetaxel treatment is associated with an increased frequency of CNS relapse