SynthesisAnnals of oncology : official journal of the European Society for Medical Oncology2013
Incidence and risk of central nervous system metastases as site of first recurrence in patients with HER2-positive breast cancer treated with adjuvant trastuzumab.
Synthesis in Annals of oncology : official journal of the European Society for Medical Oncology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 94 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
94 citing papers in PubMed, 1 synthesis or guideline pooled it, 146 citations in OpenAlex.
- Recommendations on disease management for patients with advanced human epidermal growth factor receptor 2-positive breast cancer and brain metastases: American Society of Clinical Oncology clinical practice guideline.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2014Guideline
- The potential directing role of chemokines for specific metastatic sites in breast cancer.Scientific reports · 2026Article
- Trastuzumab deruxtecan efficacy, FcRn-facilitated penetration of the blood-tumor barrier, and distribution to tumor cells in HER2+ brain metastasis model systems.Neuro-oncology · 2026Article
- Novel anti-HER2 nanobody-drug conjugates with enhanced penetration of solid tumor and BBB, reduced systemic exposure and superior antitumor efficacy.Acta pharmacologica Sinica · 2026Article
- Trastuzumab-TKI combination in HER2-Positive tumors: a FAERS-Based safety profile and multimodal analysis of Tanespimycin's role in enhancing targeting of the HSP90AA1-PI3K-Akt-mTOR axis.Frontiers in pharmacology · 2026Article
- Factors associated with developing and surviving brain metastases in patients with breast cancer: a multi-center experience.BMC cancer · 2025Article
- Invasion and metastasis in cancer: molecular insights and therapeutic targets.Signal transduction and targeted therapy · 2025Review
- A Retrospective Real-World Study of Pyrotinib in HER-2 Positive Advanced Breast Cancer.Cancer management and research · 2025Article
- Article
- Central Nervous System Metastases in Breast Cancer.Current treatment options in oncology · 2025Review
- Distinct uptake and elimination profiles for trastuzumab, human IgG, and biocytin-TMR in experimental HER2+ brain metastases of breast cancer.Neuro-oncology · 2024Article
- Long-term Outcome Analysis of Pyrotinib in Patients With HER2-Positive Metastatic Breast Cancer and Brain Metastasis: A Real-World Study.The oncologist · 2024Review
- Diagnostic and Therapeutic Updates in Leptomeningeal Disease.Current oncology reports · 2023Review
- Pyrotinib as a therapeutic for HER2-positive breast cancer.Translational cancer research · 2023Article
- Phase I Study and Cell-Free DNA Analysis of T-DM1 and Metronomic Temozolomide for Secondary Prevention of HER2-Positive Breast Cancer Brain Metastases.Clinical cancer research : an official journal of the American Association for Cancer Research · 2023Article
- Breast cancer brain metastasis: Current evidence and future directions.Cancer medicine · 2023Review
- Neurotoxicity-sparing radiotherapy for brain metastases in breast cancer: a narrative review.Frontiers in oncology · 2023Review
- Breast Cancer Brain Metastases: Achilles' Heel in Breast Cancer Patients' Care.Cancer treatment and research · 2023Article
- HER2-Directed Therapy in Advanced Breast Cancer: Benefits and Risks.OncoTargets and therapy · 2023Review
- Design and synthesis of benzodiazepines as brain penetrating PARP-1 inhibitors.Journal of enzyme inhibition and medicinal chemistry · 2022Article
34 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundCentral nervous system (CNS) disease as the site of first relapse after exposure to adjuvant trastuzumab has been reported. We carried out comprehensive meta-analysis to determine the risk of CNS metastases as the first site of recurrence in patients with HER2-positive breast cancer who received adjuvant trastuzumab.
methodsEligible studies include randomized trials of adjuvant trastuzumab administered for 1 year to patients with HER2-positive breast cancer who reported CNS metastases as first site of disease recurrence. Statistical analyses were conducted to calculate the incidence, relative risk (RR), and 95% confidence intervals (CIs) using fixed-effects inverse variance and random-effects models.
resultsA total of 9020 patients were included. The incidence of CNS metastases as first site of disease recurrence in HER2-positive patients receiving adjuvant trastuzumab was 2.56% (95% CI 2.07% to 3.01%) compared with 1.94% (95% CI 1.54% to 2.38%) in HER2-positive patients who did not receive adjuvant trastuzumab. The RR of the CNS as first site of relapse in trastuzumab-treated patients was 1.35 (95% CI 1.02-1.78, P = 0.038) compared with control arms without trastuzumab therapy. The ratio of CNS metastases to total number of recurrence events was 16.94% (95% CI 10.85% to 24.07%) and 8.33% (95% CI 6.49% to 10.86%) for the trastuzumab-treated and control groups, respectively. No statistically significant differences were found based on trastuzumab schedule or median follow-up time. No evidence of publication bias was observed.
conclusionsAdjuvant trastuzumab is associated with a significant increased risk of CNS metastases as the site of first recurrence in HER2-positive breast cancer patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.