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Neurooncol Adv
Neurooncol Adv
noa
Neuro-Oncology Advances
2632-2498
Oxford University Press US

10.1093/noajnl/vdae090.106
vdae090.106
Final Category: Radiation Therapy Advances
AcademicSubjects/MED00300
AcademicSubjects/MED00310
RADT-14 STEREOTACTIC RADIOSURGERY AND SACITUZUMAB-GOVITECAN FOR BREAST CANCER BRAIN METASTASES
Khatri Vaseem Moffitt Cancer Center, Tampa, FL, USA

Doniparthi Ajay University of South Florida, Tampa, FL, USA

Nakashima Justyn Moffitt Cancer Center, Tampa, FL, USA

Zhao Dekuang Moffitt Cancer Center, Tampa, FL, USA

Mills Matthew Moffitt Cancer Center, Tampa, FL, USA

Oliver Daniel Moffitt Cancer Center, Tampa, FL, USA

Yu Hsiang-Hsuan Moffitt Cancer Center, Tampa, FL, USA

Soliman Hatem Moffitt Cancer Center, Tampa, FL, USA

Han Hyo Moffitt Cancer Center, Tampa, FL, USA

Ahmed Kamran Moffitt Cancer Center, Tampa, FL, USA

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i32i32
© The Author(s) 2024. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Abstract

BACKGROUND

Sacituzumab-govitecan (SG) is an antibody drug conjugate (ADC) with activity against breast cancer brain metastases (BCBM). Efficacy and safety information of SG with stereotactic radiosurgery (SRS) is limited. Reports suggest SRS with ADCs may increase risk of symptomatic radiation necrosis (SRN).

METHODS

Patients treated with SG from 2020-2023 were reviewed. Patients had BCBM prior to SG and received SRS for active BM within 6 months of SG. Patients with prior leptomeningeal disease (LMD) were excluded. Kaplan-Meier method was used to estimate overall survival (OS), intracranial PFS (CNS-PFS), extracranial PFS (EC-PFS), local control (LC) and distant intracranial control (DIC). RESULTS: Between 2020-2023, 121 lesions were treated over 25 courses in 14 patients. Median follow up was 28.6 months. Median age was 60 (range 30-72). Five (36%) patients had neurologic symptoms, 7 (50%) were HR+. Eleven (9%) lesions received fractionated SRS (fSRS) and 110 (91%) single-fraction. Median dose for single fraction was 24 Gy (range 16-24), and for fSRS was 27 Gy (range 20-30) in median 5 fractions (range 3-5). Seventy-seven (63%) received SRS concurrent with SG. The median gross tumor volume (GTV) was 0.047 cc (range 0.007-17.4) and median planning target volume (PTV) was 0.14 cc (0.032-30). Six (5%) lesions were treated post-operatively. Median OS was 8.4 months (95% CI 4.2-not reached), with 12-month rate of 48%. Median CNS-PFS was 4.2 months (95% CI 1.9-6.3), with 12-month rate of 11%. Median EC-PFS was 4.4 months (95% CI 1.4-8.1), with 12-month rate of 17%. Twelve-month LC from SRS was 91%. Median DIC from SRS was 4.2 months (95% CI 2.1-7.5) with 12-month DIC rate of 12%. Two patients developed LMD. SRN occurred in 1 lesion, which received SRS prior to SG. CONCLUSIONS: SRS and SG demonstrated excellent local control and no increased risk of RN. Prospective investigation is warranted.
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