808 Metastatic Breast Cancer to the Spine: Outcomes After the Introduction of Small Molecule Inhibitors. (1st April 2022)

• Record Type: Journal Article
• Authors: Rabah, Nicholas M.; Khan, Hammad A.; Jarmula, Jakub; Hamza, Omar; Chakravarthy, Vikram; Wright, Christina; Wright, James Monroe; Steinmetz, Michael P.; Krishnaney, Ajit A.
• Is Part Of: Neurosurgery. Volume 68(2022)Supplement 1
• Page Start: 134
• Page End: 134
• Publication Date: 2022-04-01
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1227/NEU.0000000000001880_808
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract : INTRODUCTION: Over the past decade, with the development of small molecule inhibitors and immunotherapies, expanded attention is being paid to the somatic mutations expressed within a patient's individual breast tumor, especially in the case of advanced or metastatic disease. A number of mutations have been found to occur most commonly in patients with metastatic breast cancer, including TP53, PI3K, CDH1, and MAP3K. Specifically, with regards to patients with metastases to bone, PIK3 mutations have been found to increase in frequency. METHODS: This is a retrospective study of patients who underwent treatment (surgery/radiation) at a tertiary care center for their diagnosis of breast cancer metastatic to the spine between 2010 and 2020. Review of peripheral sample gene sequencing reports was conducted to calculate the prevalence of different somatic gene mutations within our population. The use of small molecule inhibitors in the post-treatment period was determined and patient post-treatment mortality was calculated in order to elucidate the effect of systemic therapy on overall survival. RESULTS: 77 patients were included in our final analysis. Within our population of spine metastases patients, 44 (57%) were found to have a PI3K mutation, followed by 20 (26%) with a TP53 mutation. Furthermore, those patients given targeted molecular therapies in the post-treatment period were found to have a median overall survival of 1356 days. In comparison, those who did not receive targeted molecular therapies were found to have a median overall survival of 503 days (p<0.001). CONCLUSIONS: The results of the present study demonstrate that not only is there an increased prevalence of PI3K mutations within spine metastases in comparison to the general metastatic breast cancer population, there is also a significant mortality benefit with adding targeted molecular therapies to the patient's post-operative treatment plan.