Evidence map›Paper›PMID 42727421›Full record

ArticleESMO open2026

Clinically actionable genomic alterations in breast cancer brain metastases.

G Griguolo, A Collesei, E Lazzarini, M Bottosso, M V Dieci, S Fineberg, L Bauchet, G Landa, F Miglietta, J Jacob and 9 more

Abstract read
In one paragraph

Article in ESMO open, 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

19 authors.

G GriguoloDepartment of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Division of Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy.
A ColleseiBioinformatics Unit, Clinical Research Unit, Istituto Oncologico Veneto IRCCS, Padova, Italy.
E LazzariniBasic and Translational Oncology Unit, Istituto Oncologico Veneto IRCCS, Padova, Italy.
M BottossoDivision of Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy.
M V DieciDepartment of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Division of Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy. Electronic address: mariavittoria.dieci@unipd.it.
S FinebergPathology Department, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, USA.
L BauchetDepartment of Neurosurgery, Gui de Chauliac Hospital-CHU, Montpellier University Medical, Center, Montpellier, France; Institute of Functional Genomics, Montpellier University, CNRS, INSERM, Montpellier, France.
G LandaDepartment of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Division of Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy.
F MigliettaDepartment of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Division of Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy.
J JacobDepartment of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, USA.
V RigauDepartment of Pathology, University of Montpellier, Montpellier, France.
M La CommareDepartment of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Division of Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy.
L TrovòDepartment of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Division of Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy.
M FassanDepartment of Medicine, University of Padova, Padova, Italy; Istituto Oncologico Veneto IRCCS, Padova, Italy.
W JacotMedical Oncology Department, Institut du Cancer de Montpellier-University of Montpellier, Montpellier, France.
A P Dei TosDepartment of Medicine, University of Padova, Padova, Italy; Institute of Anatomic Pathology, Department of Integrated Diagnostics, Padua University-Hospital, Padova, Italy.
S IndraccoloDepartment of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Basic and Translational Oncology Unit, Istituto Oncologico Veneto IRCCS, Padova, Italy.
A DarlixMedical Oncology Department, Institut du Cancer de Montpellier, Institut de Génomique, Fonctionnelle, INSERM, CNRS-University of Montpellier, Montpellier, France.
V GuarneriDepartment of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Division of Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBreast cancer brain metastases (BCBMs) represent a critical unmet clinical need in metastatic breast cancer (MBC) and the identification of novel therapeutic targets is urgently needed in this context. In this study, we describe clinically actionable targets in BCBMs using comprehensive genomic profiling. PATIENTS AND

methodsGenomic DNA was extracted from formalin-fixed paraffin-embedded archival BCBM samples and analyzed using the commercially available Agilent SureSelect V6 whole exome sequencing (WES) kit and an Illumina NovaSeq 6000 platform. Pathogenic alterations were classified as actionable alterations (AAs) if they met the updated MBC or tumor-agnostic ESMO Scale for Clinical Actionability of Molecular Targets (ESCAT) I or II criteria of the ESCAT scale.

resultsWES data from 56 BCBM samples were available [33.9% hormone receptor (HR)-negative/human epidermal growth factor receptor (HER)2-negative; 25.0% HR-positive/HER2-negative; and 38% HER2-positive]. ESCAT I/II AAs were detected in 76.8% (n = 43) of all BCBMs and the most frequently detected AAs were in genes involved in the homologous recombination repair pathway (BRCA1/BRCA2/PALB2; 53.6% overall). Biallelic inactivation of BRCA1, BRCA2, or PALB2 was observed in 19.6% of samples, with higher rates in HER2-negative BCBMs (26% in HR-negative /HER2-negative and 21% in HR-positive/HER2-negative). ESCAT I/II PIK3CA/AKT1/PTEN pathway alterations were present in 48.2% of samples and, in particular, in 50% of HR-positive/HER2-negative BCBMs. No ESR1 mutation was detected in HR-positive/HER2-negative BCBMs. The prognostic impact of previously described AAs was evaluated overall and according to breast cancer subtype. Twenty-three BCBMs (41%) were classified as HER2-positive; among these, 3 (13%) presented a hotspot PIK3CA mutation and 7 (30%) presented a PTEN deletion. Among patients with HER2-positive BCBMs, the identification of a hotspot PIK3CA mutation was significantly associated with worse prognosis.

conclusionsESCAT I/II actionable genomic alterations are frequent in BCBMs, highlighting the potential for genomically targeted treatments in this setting.

Indexed as

brain metastasesbreast cancerESCATnext-generation sequencing

Identifiers

PMID42727421
PMCPMC13583568

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