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Purpose: we used the real-world data of Chinese patients to describe clinicopathological characteristics of patients with breast cancer brain metastases (BCBM) and to investigate survival after diagnosis of brain metastases (BM). Methods: The clinicopathological characteristics of 700 patients with BCBM at the fifth Medical Center of Chinese PLA General Hospital between 2003 and 2021 were retrospectively reviewed. Information was collected from the electronic medical records, including patient demographics, tumor characteristics, and dates of diagnosis of original breast carcinoma and subsequent metastases. Sites and number of metastatic lesions were also recorded, along with data on treatments and outcomes. The prognostic and predictive effects of these clinicopathological variables in BCBM were analyzed. Results: The median age at diagnosis of primary breast cancer was 44 years (range, 22-80 years) and all patients were female. Among the 700 patients with BCBM, 30.0%, 49.7%, 18.9%, 1.4% had Luminal, HER2 positive, triple-negative and unknown subtypes, respectively. Based on available clinical information, the proportions of extracranial metastasis at diagnosis included bone (63.7%), lymph nodes (61.6%), lung (55.1%), liver (50.1%), the soft tissues of the thoracic wall (26.1%) and bone marrow (4.9%).The median time from the diagnosis of breast cancer to the development of BM was 52.0 months [95% confidence interval (CI), 44.3-59.7], 36.0 months (95%CI, 31.9-40.1), and 29.0 months (95%CI, 22.4-35.6) for patients with Luminal, HER2 positive and triple-negative, respectively (p Table 1.patient characteristics (n=700)Parametern (%)Mean age, y, at diagnosis (range)44(22-80)Stage at initial diagnosis of cancerI89(12.7)II342(48.9)III167(23.9)IV69(9.9)unknown33(4.7)Molecular subtypesLuminal A/B211(30.0)HER2-positive347(49.7)TNBC132(18.9)Unknown10(1.4)Site of first metastasisBrain128(18.3)Others572(81.7)Number of BM at time of BM diagnosis1189(27.0)248(6.9)≥3454(64.9)Unknown9(1.3)Visceral metastases at diagnosis of BMliver351(50.1)lung386(55.1)bone446(63.7)lymph nodes431(61.6)the soft tissues of the thoracic wall183(26.1)bone marrow34(4.9) Citation Format: Tao Wang, Huiqiang Zhang, Feng Li, Xia Wu, Jinmei Zhou, Shao hua Zhang, Li Bian, Ze fei Jiang. The real word study on clinical features and prognostic factors of Chinese breast cancer patients with brain metastasis [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-21-04.

Rationale: Breast cancer has become the leading cause of cancer mortality in women. Although immune checkpoint inhibitors targeting programmed death-1 (PD-1) are promising, it remains unclear whether PD-L1 expression on circulating tumor cells (CTCs) has predictive and prognostic values in predict and stratify metastatic breast cancer (MBC) patients who can benefit from anti-PD-1 immunotherapy. Methods: Twenty six MBC patients that received anti-PD-1 immunotherapy were enrolled in this study. The peptide-based Pep@MNPs method was used to isolate and enumerate CTCs from 2.0 ml of peripheral venous blood. The expression of PD-L1 on CTCs was evaluated by an established immunoscoring system categorizing into four classes (negative, low, medium, and high). Results: Our data showed that 92.3% (24/26) of patients had CTCs, 83.3% (20/26) of patients had PD-L1-positive CTCs, and 65.4% (17/26) of patients had PD-L1-high CTCs. We revealed that the clinical benefit rate (CBR) of patients with a cut-off value of ≥ 35% PD-L1-high CTCs (66.6%) was higher than the others (29.4%). We indicated that PD-L1 expression on CTCs from MBC patients treated with anti-PD-1 monotherapy was dynamic. We demonstrated that MBC patients with a cut-off value of ≥ 35% PD-L1-high CTCs had longer PFS (P< 0.05) and OS (P< 0.01) compared with patients with a cut-off value of < 35% PD-L1-high CTCs. Conclusion: Our findings suggested that PD-L1 expression on CTCs could predict the therapeutic response and clinical outcomes, providing a valuable predictive and prognostic biomarker for patients treated with anti-PD-1 immunotherapy. Citation Format: Ying Zhou, Jinmei Zhou, Haoyuan Shi, Zhiyuan Hu, Yanlian Yang, Zefei Jiang, Tao Wang. Prognostic relevance of PD-L1 expression on circulating tumor cells in metastatic breast cancer patients treated with anti-PD-1 immunotherapy [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-02-12.

Background: Circulating tumor cell (CTC) and serum HER2 ECD can all reflect an aggressive tumor behavior. We performed this prospective, monocenter, double-blinded study to investigate the potential clinical significance of combined detection of CTC and serum HER2 ECD for advanced breast cancer patients with histological HER2-positivity. Methods: A total of 88 eligible patients were enrolled in the present study from April 2012 to October 2013. We used Cell search system and ADVIA Centaur System to detect CTC and serum HER2 ECD respectively. Patients received systemic treatment according to national and international guidelines. Results: Twenty nine (33%) patients had ≥5 CTC, seventy three (83%) patients had serum HER2 ECD values of at least 15ng/ml, twenty seven (30.7%) patients had both elevated CTC and ECD values and fourteen (15.9%) patients had both normal CTC and ECD values. Patients with both normal CTC and serum HER2 ECD values exhibited a significantly longer median PFS than patients with both elevated values (9.0 months versus 2.8 months, p=0.023) and exhibited a trend toward longer PFS compared with patients with elevated CTC or ECD values (9.0 months versus 4.2 months, p=0.065), patients with both or one elevated values showed similar median PFS (2.8 months versus 4.2 months, p=0.211) (Figure1). Conclusions: The combined detection of CTC and serum HER2 ECD showed prognostic significance for HER-2 positive advanced breast cancer patients, patients with both normal values exhibited longer median PFS than others. Citation Format: Zefei Jiang, Jinmei Zhou, Tao Wang, Yi Liu, Lei Li, Huiqiang Zhang, Shaohua Zhang, Li Bian, Santai Song. The combined detection of CTC and serum HER2 ECD predict PFS for HER2-positive advanced breast cancer patients [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P4-01-19.