Nirl-06 Is the Presence of Neoplastic Meningitis Associated With a Worse Prognosis in Real-World Patients With Breast Cancer and Brain Metastases?

BACKGROUND Central nervous system (CNS) metastases are a severe and frequent scenario in patients with breast cancer; CNS metastases can be divided into parenchymal metastases (brain metastases) or neoplastic meningitis (leptomeningeal disease). The occurrence of both in the same patient is a common picture but scantly reported. OBJECTIVE To measure the association of brain metastases with or without meningeal involvement in patients with breast cancer and brain metastases. METHODS A prospectively acquired database from patients with breast cancer and central nervous system metastases was retrospectively analyzed. RESULTS In 659 patients, 292 (44%) had brain metastases (BM), 169 (26%) had neoplastic meningitis (NM), and 198 (30%) had both (BM+NM). The median overall survival (MOS) in the whole cohort was 9.59 months (95%CI 8.0 – 11.2); in those with BM, the MOS was 12.2 months (95%CI 10 – 14.5); in the NM group, the MOS was 5.8 months (95%CI 4.3 – 7.2 months); and for those on the group with both BM and NM (BM+NM) the MOS was 10.3 months (95%CI 8.0 – 26.7), P <0.001. After statistical adjustment, the difference in survival between BM and BM+NM persisted. CONCLUSION The presence of meningeal involvement in patients with breast cancer and brain metastases is associated with a worse prognosis.