P11.08.A CLINICAL OUTCOMES AND BIOMARKER SHIFTING OF BREAST CANCER BRAIN METASTASES - A SINGLE INSTITUTION EXPERIENCE
Bibliographic record
Abstract
Abstract BACKGROUND Breast cancer brain metastases (BCBMs) are a feared complication of breast cancer and associated with a poor prognosis. The molecular and biological events that give rise to BCBMs are not fully understood. The project aims are to characterize the clinicopathological outcomes of patients who underwent surgical resection or biopsy of BCBMs at London Health Sciences Centre (LHSC) and further compare the biomarker profiles between primary tumor and BM. MATERIAL AND METHODS Patients who had BCBMs surgically-resected or biopsied at LHSC were identified. Retrospective chart review was conducted to collect patients demographics, details on primary BC and BM diagnoses and treatments, pathology details, and clinical outcomes. Kaplan-Meier curves were generated and uni- and multivariate Cox-regression analyses were conducted to determine clinical outcome predictors. RESULTS Seventy-five female patients were identified. Mean age at BCBM diagnosis was 56.1 years and mean time to developing BCBM was 5.4 years (range: 0-23.0 years). Triple-negative (18/75, 24.0%) and HER2+ (14/75, 18.7%) were the most common subtypes. Median overall survival (OS) after BCBM diagnoses was 2.4 years. Solitary BCBM (p=0.0276) and no extracranial systemic disease (p=0.0276) were associated with longer OS after BCBM diagnosis. 51 patients had paired immunohistochemistry (IHC) markers of their primary BC and BMs. 12/51 (23.5%) patients exhibited a subtype switch with hormone receptor loss (5/12, 41.7%) being the most common change. Univariate Cox-regression analyses for these 51 patients demonstrated that triple-negative subtype (HR 2.81, p=0.0075), multiple BMs (HR 3.23, p=0.0024), neurological deficits (HR 3.06, p=0.0058), tumor >3 cm (HR 2.84, p=0.013), and hydrocephalus (HR 4.13, p=0.014) were negative prognostic factors. After multivariate Cox-regression, only triple-negative subtype (3.52, p=0.0033) and multiple BMs (2.34, p=0.047) remained significant. Subtype switching did not appear to impact OS (p=0.27). CONCLUSION The management of BCBM remains challenging with overall survival remaining poor, especially in those with triple-negative disease, multiple BMs, and widespread metastatic disease. Within our cohort, a noticeable proportion of patients exhibited biomarker profile shifting between the primary BC and BCBM. This may have clinical implications and further investigations are required.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".