“The brain is a common and catastrophic site of metastasis for breast cancer patients,” said Lee. “Our study showed that despite the large degree of similarity between the initial breast tumor and the brain metastatic tumor, there were enough alterations to support comprehensive profiling of metastases to potentially alter the course of treatment.”
There are many types of breast cancers, and about 20 percent of them are identified as HER2-positive, meaning the cancer cells have more of a protein called HER2 that causes the cells to grow faster than those with normal levels of the protein. These patients’ cancers typically respond to targeted therapies. However, breast cancer patients with brain metastases who are identified as HER2-negative do not respond favorably to the same therapies.
Lee’s research team set out to determine if there were molecular differences in the primary breast tumors and their patient-matched brain metastatic tumors that would enhance treatment options.
Little research is available because there are few opportunities to study primary breast tissue with their patient-matched brain metastases. The research team tested tumors from 20 patients from two academic institutions, the University of Pittsburgh and the Royal College of Surgeons in Ireland
. Among the discoveries was that the primary tumor initially identified as HER2-negative actually switched to HER2-positive in the metastatic brain tumor.
“This now means we can screen for presence of HER2 so that we can change and target the therapy to improve outcomes for our patients,” said Dr. Lee.
Additional authors on this study are Nolan Priedigkeit, B.S., Yijing Chen, B.S., Ahmed Basudan, B.S., Rebecca J. Watters, Ph.D., Roby Thomas, M.D., Peter C. Lucas, M.D., Ph.D., Rohit Bhargava, M.D., Ronald L. Hamilton, M.D., Shannon L. Puhalla, M.D., Nancy E. Davidson, M.D., Steffi Oesterreich, Ph.D., and Adam M. Brufsky, M.D., Ph.D., all of UPCI; Ryan J. Hartmaier, Ph.D., and Juliann Chmielecki, Ph.D., both of the Foundation Medicine, Cambridge, Massachusetts; Damir Vareslija, Ph.D., and Leonie Young, Ph.D., both of the Royal College of Surgeons in Ireland; and Jose P. Leone, M.D., of the University of Iowa.
Several of the authors disclosed conflicts of interest, which can be viewed on the JAMA Oncology publication.