Evidence map›Paper›PMID 39073687›Full record

ArticleJournal of neuro-oncology2024

Durable responses to trastuzumab deruxtecan in patients with leptomeningeal metastases from breast cancer with variable HER2 expression.

David Rogawski, Toni Cao, Qian Ma, Meaghan Roy-O'Reilly, Lilian Yao, Nova Xu, Seema Nagpal

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
  4. Review
  5. Article
  6. Review
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

7 authors.

David RogawskiDivision of Neuro-Oncology, Department of Neurology and Neurological Sciences, Stanford Medicine, Stanford, CA, 94305, USA. rogawski@stanford.edu.ORCID http://orcid.org/0009-0003-5587-5832
Toni CaoDivision of Neuro-Oncology, Department of Neurology and Neurological Sciences, Stanford Medicine, Stanford, CA, 94305, USA.
Qian MaDivision of Neuro-Oncology, Department of Neurology and Neurological Sciences, Stanford Medicine, Stanford, CA, 94305, USA.
Meaghan Roy-O'ReillyDivision of Neuro-Oncology, Department of Neurology and Neurological Sciences, Stanford Medicine, Stanford, CA, 94305, USA.
Lilian YaoDivision of Neuro-Oncology, Department of Neurology and Neurological Sciences, Stanford Medicine, Stanford, CA, 94305, USA.
Nova XuDivision of Neuro-Oncology, Department of Neurology and Neurological Sciences, Stanford Medicine, Stanford, CA, 94305, USA.
Seema NagpalDivision of Neuro-Oncology, Department of Neurology and Neurological Sciences, Stanford Medicine, Stanford, CA, 94305, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEmerging data suggest that trastuzumab deruxtecan (T-DXd) is an active treatment for brain metastases from HER2 + breast cancer. We aimed to characterize the activity of T-DXd in the treatment of leptomeningeal metastases (LM) from a range of HER2-altered cancers.

methodsWe reviewed neuro-oncology clinic records between July 2020 and December 2023 to identify patients who received T-DXd to treat LM.

resultsOf 18 patients identified, 6 had HER2 + breast cancer, 8 had HER2-low/negative breast cancer, 2 had HER2 + gastroesophageal cancer, and 2 had HER2-mutant non-small cell lung cancer (NSCLC). 10/18 (56%) patients had cytologically confirmed LM by CSF cytology or circulating tumor cell (CTC) capture. A partial response (PR) on MRI using the EORTC/RANO-LM Revised-Scorecard occurred in 4/6 (67%) patients with HER2 + breast LM, 2/8 (25%) patients with HER2-low/negative breast cancer, and 0/4 (0%) patients with HER2 + gastroesophageal cancer or HER2-mutant NSCLC. Median overall survival after initiating T-DXd was 5.8 months. Survival after initiating T-DXd was numerically longer for HER2 + breast cancer patients compared with HER2-low/negative breast and HER2-altered non-breast cancer patients (13.9 months vs. 5.2 months and 4.6 months, respectively). Landmark analysis showed that patients with radiologic LM response to T-DXd by 2.5 months had longer survival than non-responders (14.2 months vs. 2.6 months, HR 0.18, 95% CI 0.05-0.63, p < 0.05), and landmark analyses at 3.5 and 4.5 months after starting T-DXd showed a similar but nonsignificant trend.

conclusionT-DXd induces LM responses in a subset of patients, and such responses may be associated with prolongation of survival. Prospective trials are needed to clarify the role of T-DXd in treating LM and which patients are most likely to benefit.

Indexed as

Breast NeoplasmsErb-b2 Receptor Tyrosine KinasesTrastuzumabAdultAgedAntineoplastic Agents, ImmunologicalCamptothecinFemaleFollow-Up StudiesHumansImmunoconjugatesMeningeal CarcinomatosisMeningeal NeoplasmsMiddle AgedPrognosisRetrospective StudiesAntineoplastic Agents, ImmunologicalCamptothecinERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesImmunoconjugatesTrastuzumabtrastuzumab deruxtecanAntibody-drug conjugateHER2-altered cancersLeptomeningeal metastasesTrastuzumab deruxtecan

Identifiers

PMID39073687

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.