e13130 Background: Triple-negative breast cancer patients with brain metastasis (TNBC-BM) have extremely poor prognosis, posing significant clinical challenges. While immunotherapy combined with chemotherapy has improved the treatment of advanced triple-negative breast cancer, its efficacy and prognostic determinants in TNBC-BM patients require further elucidation. Methods: This retrospective study enrolled patients with TNBC-BM treated at the PLA General Hospital and the Cancer Hospital, Chinese Academy of Medical Sciences (CHCAMS) between January 2015 and October 2024. Clinicopathological characteristics and treatment regimens were collected. The primary endpoint was overall survival after brain metastasis (BMOS). Survival analysis was performed using the Kaplan-Meier method, log-rank test, and Cox proportional hazards model to identify independent prognostic factors. To further evaluate the efficacy of immunotherapy, propensity score matching (PSM) was applied to balance baseline characteristics between patients who receive immunotherapy or not. Results: A total of 161 patients were included. By the final follow-up date (October 31, 2025), 134 patients (83.23%) died, with a median BMOS of 13 months (95% CI: 11–16). Univariate and multivariate Cox regression analyses identified the following as independent prognostic factors. ECOG performance status 110 g/L (HR = 0.58, 95% CI: 0.38–0.90, P = 0.015), and receipt of immunotherapy after brain metastasis (HR = 0.39, 95% CI: 0.23–0.66, P < 0.001) were associated with a more favorable prognosis . Presence of liver metastasis (HR = 3.16, 95% CI: 1.95–5.13, P < 0.001), distant lymph node metastasis (HR = 1.47, 95% CI: 1.01–2.16, P = 0.047) were associated with a poorer prognosis. In the PSM-adjusted subgroup analysis, patients receiving immunotherapy had a median BMOS of 19 months (95% CI: 12–NA), compared to 10 months (95% CI: 5–16) for those not receiving immunotherapy. Immunotherapy was associated with a 48% reduction in the risk of death (HR: 0.52, P = 0.022). Conclusions: TNBC-BM patients with good performance status and absence of anemia at BM diagnosis have superior survival outcomes, while the presence of extracranial metastases, particularly liver metastasis, suggests a poorer prognosis. Therapeutically, TNBC-BM patients derived survival benefits from immunotherapy. Prospective studies are warranted to further define the precise patient population that benefits from this treatment approach.
Wang et al. (Thu,) studied this question.