Evidence map›Paper›PMID 30726965›Full record

ArticleNeuro-oncology2019

Stereotactic radiosurgery with concurrent HER2-directed therapy is associated with improved objective response for breast cancer brain metastasis.

Joseph M Kim, Jacob A Miller, Rupesh Kotecha, Samuel T Chao, Manmeet S Ahluwalia, David M Peereboom, Alireza M Mohammadi, Gene H Barnett, Erin S Murphy, Michael A Vogelbaum and 5 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 4 pooled it
6.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 4 syntheses or guidelines pooled it, 55 citations in OpenAlex.

  1. Pooled it
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  5. Observational
  6. Concurrent systemic treatment during stereotactic radiosurgery for breast cancer brain metastasis - analysis of survival outcomes and propensity score matching analysis.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 1 country.

Joseph M KimSchool of Medicine, Case Western Reserve University, Cleveland Clinic, Cleveland, Ohio.
Jacob A MillerDepartment of Radiation Oncology, Stanford Cancer Institute, Stanford University Medical Center, Palo Alto, California.
Rupesh KotechaDepartment of Radiation Oncology, Miami Cancer Institute, Miami, Florida.
Samuel T ChaoCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Manmeet S AhluwaliaCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
David M PeereboomCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Alireza M MohammadiCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Gene H BarnettCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Erin S MurphyCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Michael A VogelbaumCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Lilyana AngelovCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Jame AbrahamCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Halle MooreCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
G Thomas BuddCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
John H SuhCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Cleveland Clinic Lerner College of Medicine · USCleveland Clinic · USMiami Heart Research Institute · USStanford Medicine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with breast cancer positive for human epidermal growth factor receptor 2 (HER2) remain at high risk of intracranial relapse following treatment and experience increased rates of intracranial failure after stereotactic radiosurgery (SRS). We hypothesized that the addition of concurrent lapatinib to SRS would improve intracranial complete response rates.

methodsPatients with newly diagnosed HER2-amplified breast cancer brain metastases from 2005-2014 who underwent SRS were included and divided into 2 cohorts based on timing of treatment with lapatinib. Outcome variables included the proportion of patients who achieved an intracranial complete response or progressive disease according to the RECIST 1.1 criteria, as well as individual lesion response rates, distant intracranial failure, and radiation necrosis.

resultsEighty-four patients with 487 brain metastases met inclusion criteria during the study period. Over 138 treatment sessions, 132 lesions (27%) were treated with SRS and concurrent lapatinib, while 355 (73%) were treated with SRS without lapatinib. Compared with patients treated with SRS alone, patients treated with concurrent lapatinib had higher rates of complete response (35% vs 11%, P = 0.008). On a per-lesion basis, best objective response was superior in the concurrent lapatinib group (median 100% vs 70% reduction, P < 0.001). Concurrent lapatinib was not associated with an increased risk of grade 2+ radiation necrosis (1.0% with concurrent lapatinib vs 3.5% without, P = 0.27). Lapatinib had no protective effect on distant intracranial failure rates (48% vs 49%, P = 0.91).

conclusionThe addition of concurrent lapatinib to SRS was associated with improved complete response rates among patients with HER2-positive brain metastases.

Indexed as

AdultAgedAged, 80 and overAntineoplastic AgentsBrain NeoplasmsBreast NeoplasmsCombined Modality TherapyErb-b2 Receptor Tyrosine KinasesFemaleFollow-Up StudiesHumansLapatinibMiddle AgedPrognosisRadiosurgeryRetrospective StudiesAntineoplastic AgentsERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesLapatinibbrain metastasisbreast cancerHER2lapatinibstereotactic radiosurgery

Identifiers

PMID30726965
PMCPMC6502492
OpenAlexW2914250269

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.