Evidence map›Paper›PMID 41963546›Full record

ArticleNeurosurgical review2026

The impact of CHEK2 status on radiosurgical outcomes in breast cancer brain metastases.

Paul M Harary, Yusuke S Hori, Ahed H Kattaa, Sze Kiat Tan, Fred C Lam, Neeraj Kalra, Nirmeen Zagzoog, Armine Tayag, Louisa Ustrzynski, Sara C Emrich and 5 more

Abstract read
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In one paragraph

Article in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Paul M HararyDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94305, USA.
Yusuke S HoriDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94305, USA. yshori@stanford.edu.
Ahed H KattaaDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94305, USA.
Sze Kiat TanDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94305, USA.
Fred C LamDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94305, USA.
Neeraj KalraDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94305, USA.
Nirmeen ZagzoogDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94305, USA.
Armine TayagDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94305, USA.
Louisa UstrzynskiDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94305, USA.
Sara C EmrichDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94305, USA.
Iris C GibbsDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA.
Gordon LiDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94305, USA.
Atsushi KunoDepartment of Pharmacology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
David J ParkDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94305, USA.
Steven D ChangDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94305, USA. sdchang@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Breast cancer (BC) is a leading cause of cancer-related morbidity and mortality in women, with many patients developing brain metastases (BM). Stereotactic radiosurgery (SRS) has become a standard treatment for BCBM, achieving local control rates exceeding 90%. However, some patients remain resistant to SRS, and genetic factors may influence treatment outcomes. We aimed to evaluate the impact of CHEK2 mutations on radiation response and local control in patients with BCBM treated with SRS. We analyzed 11 patients with confirmed pathogenic CHEK2 mutations and 43 total BCBM treated with CyberKnife SRS. Data on demographics, performance status, and tumor characteristics were collected. Primary endpoints included local control and distant BM-free survival, while secondary endpoints were the rate of post-SRS leptomeningeal disease (LMD) and the need for additional intervention. The female-to-male ratio was 10:1, with a median age at BC diagnosis of 52 years (range 35-76). Receptor status showed 7 patients were HR+/HER2-, 2 patients were HR+/HER2+, 1 patient was HR-/HER2+, and 1 patient had triple-negative breast cancer. There was a median of 3 BCBM (range 1-6) at presentation, with 7 patients also having extracranial metastasis. Median age at SRS was 55 years (range 41-86), and all patients received systemic chemotherapy prior to SRS. Median maximum diameter of BCBM was 9.0 mm (range 2.6-32.0), with a median prescribed dose of 22 Gy (range 20-30). Median radiographic follow-up was 18.7 months (range 1.9-107.8). Local control rates were 97.8%, 90.9%, and 72.7% at 3, 6, and, 12 months, respectively. Four patients developed LMD and 4 experienced distant recurrence, requiring additional treatment. Local control and distant recurrence rates in patients with CHEK2 mutations were notably unfavorable compared to prior reports of SRS outcomes for BCBM. This suggests CHEK2 as a potential marker of poor prognosis in BCBM, although direct comparisons to CHEK2-wildtype patients are needed.

Indexed as

Brain NeoplasmsBreast NeoplasmsCheckpoint Kinase 2RadiosurgeryAdultAgedFemaleHumansMaleMiddle AgedMutationTreatment OutcomeCheckpoint Kinase 2CHEK2 protein, humanBrain metastasesBreast cancerCHEK2Radiation responseRadiosurgery

Identifiers

PMID41963546

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Registered trials

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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.