Real-World Outcomes with Sacituzumab Govitecan among Breast Cancer patients with Central Nervous System metastases

Real-World Outcomes with Sacituzumab Govitecan among Breast Cancer patients with Central Nervous System metastases | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Real-World Outcomes with Sacituzumab Govitecan among Breast Cancer patients with Central Nervous System metastases Thomas Grinda, Stefania Morganti, Liangge Hsu, Tae-Kyung Yoo, and 8 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5348788/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 05 Mar, 2025 Read the published version in npj Breast Cancer → Version 1 posted 9 You are reading this latest preprint version Abstract Central nervous system (CNS) metastases are associated with poor prognosis in patients with metastatic breast cancer (MBC). In this retrospective study, we investigated the activity of sacituzumab govitecan (SG) in 33 patients with HER2-negative MBC and CNS metastases, including active, stable/treated, and leptomeningeal disease (LMD). SG demonstrated a modest CNS objective response rate of 4/30 (13%) and median CNS-progression-free survival of 2.9 months (95%CI:2.0-4.3) in a heavily pretreated population. Biological sciences/Cancer/Breast cancer Biological sciences/Cancer/Metastases Figures Figure 1 Figure 2 Figure 3 Main text Central nervous system (CNS) metastases, including brain metastases (BM) and leptomeningeal disease (LMD), occur in one-quarter of patients with metastatic breast cancer (MBC), with varying incidence across different subtypes 1,2 . As the overall survival (OS) of patients with MBC is increasing, and the incidence of CNS metastases continues to rise across all tumor subtypes without any signs of plateauing, managing patients with CNS metastases from breast cancer is a major challenge 1,3 . CNS metastases encompass distinct clinical scenarios with specific therapeutic implications and prognosis. The FDA has defined brain metastases based on their clinical status as 1) stable or 2) active. Stable brain metastases refer to patients who have previously received local therapy, such as radiation or resection, and their CNS disease is stable at the time of therapy initiation. Active brain metastases refer to patients with new untreated lesions or previously treated lesions that have not been subjected to CNS-directed therapy since documented progression 4 . There are no FDA-approved systemic therapies that improve progression-free survival (PFS) or OS in patients with active or stable HER2-negative BM. Evaluation of novel agents for these patients is urgently needed. Antibody-drug conjugates (ADCs) are an emerging therapeutic class. Both trastuzumab emtansine and trastuzumab deruxtecan (TDXd) have demonstrated intracranial response improvement in randomized trials of patients with HER2-positive CNS metastases 5–7 . The Phase 3b/4 DESTINY-Breast study12 evaluated T-DXd in patients with HER2+ breast cancer, including those with active or stable BM (n=263). These patients had an objective response rate in the CNS (ORR-CNS) and a 12-month CNS progression-free survival (CNS-PFS) rate of 79.2% (95%CI 70.2-88.3) and 57.8% (95%CI 48.2-66.1) for patients with stable BM and 62.3% (95%CI 50.1-74.5) and 60.1% (95%CI 49.2-69.4) for patients with active BM, respectively 8 . Limited data are available for patients with CNS metastases from hormone receptor-positive and triple-negative breast cancer (TNBC) MBC, which represent 45% and 25% of patients with CNS metastases, respectively 1 . Sacituzumab govitecan (SG) is an ADC composed of an anti-TROP2 antibody linked to an active metabolite of irinotecan. SG has demonstrated significant PFS and OS benefit over standard chemotherapy in pretreated patients with TNBC and HR-positive/HER2-negative (HR+/HER2-) MBC 6,7 . However, these trials excluded patients with active CNS metastases or LMD. A Phase 0 study demonstrated that the SG payload achieved therapeutic levels in brain metastases and induced intracerebral responses with ORR-CNS of 50% in 13 patients with MBC of all subtype 9 ; however, limited data on intracranial outcomes in MBC patients exist. In this retrospective, observational, real-world data study, we report the activity of SG in patients with HR+/HER2- and TN MBC using a prospectively maintained institutional database of patients with MBC at Dana-Farber Cancer Institute (DFCI) and electronic health records collection. The objective of our study was to evaluate the real-world activity of SG in patients with CNS metastases, considering whether the metastases were active or treated/stable, and LMD, using the RANO response assessment criteria for BM and LMD, with confirmation through central radiologic review 10,11 . Treatment response was retrospectively categorized as objective response, stable disease, and progressive disease in the CNS and non-CNS. An independent radiologist confirmed CNS-ORR using RANO criteria 10 . Because clinical status was not uniformly available at each restaging, we used a modified version of the RANO criteria where clinical status was not included in the response assessment. Thirty-three patients were included (Table 1), with 18 (54.5%) having treated/stable, 7 (21.2%) having active CNS metastases, and 8 (24.3%) having LMD. Ten (30.3%) and 14 (42.4%) were HR+/HER2- and TNBC, respectively. The median age at SG initiation was 56.7 years. Only one patient had CNS metastasis with no extra-CNS involvement; while 18/33 (54.5%) patients had at least pulmonary and/or hepatic involvement, with a median of 3 (range, 1-6) metastatic sites at SG initiation. Patients were heavily pretreated, with a median of 3 (0-10) lines of therapy in the metastatic setting before SG initiation, and three patients received prior TDXd. In patients with stable brain metastases, the median time from prior CNS-directed radiotherapy to SG start was 2.3 months (range 0.5-44.0). Among patients with LMD, 7/8 had associated BM, and all patients had extra CNS metastases. Two had a positive cerebrospinal fluid (CSF), one had a negative CSF, and five did not have a lumbar puncture. The median follow-up for the entire cohort was 6.7 months (IC95% 3.1–10.0). Thirty (90.9%) and 29 (87.9%) patients had evaluable responses in the CNS and non-CNS, respectively, with a time interval between initiation of SG and first imaging restaging of 1.6 months (95%CI 1.4-2.3) for CNS responses and 2.1 months (95%CI: 1.8-2.6) for non-CNS responses. The CNS-ORR was 12.5% for patients with treated/stable BM, 0% for patients with active BM; 11.1% for HR+/HER2-, and 14.3% for TNBC (Table 2, Figure 2 and Supplementary Table 1). Moreover, no cases of non-CNS objective response (non-CNS-ORR) were observed in patients with treated/stable and active BM. The CNS clinical benefit rate (CNS-CBR: response + stable disease ≥6 months) was 37.5% and 14.3% for patients with treated/stable and active BM, respectively. 7/8 patients with LMD were evaluable for response according to RANO-LM criteria 11 . For them, the CNS-ORR and CNS-CBR were 28.6% and 14.3%, respectively. The median CNS-PFS was similar not between patients with stable BM (3.4 mo; 95%CI: 2.2-10.0), patients with active BM (1.9 months; [95%CI: 1.2-16.5]), and those with LMD (2.1 months; [95%CI: 0.4-7.7]) (Figure 3). Additionally, the CNS-PFS of patients with HR+/HER2- and TNBC were similar (2.0 months; [95%CI: 1.2-7.7] and 3.2 months; [95%CI: 2.2-5.1], respectively) (Supplementary Figure 1). The median OS in the population was 6.9 mo (95%CI: 3.1-10.2). OS did not differ significantly between patients with stable BM (10.0 months; [95%CI: 4.3-15.9]) and those with active BM (3.1 months; [95%CI: 1.9-21.6]; p =0.17) but was longer in patients with stable BM compared to those with LMD (3.8 months; [95% CI: 1.7-11.9]) (Figure 3). A total of 32 patients discontinued SG due to progression, and one patient due to toxicity. Most patients (53.1%) experienced both CNS and extra-CNS disease progression. Out of the five patients who died while receiving SG, two suffered from neurological death (Table 3). In our cohort of 33 patients with MBC with CNS metastases, SG demonstrated modest CNS and non-CNS activity with a CNS-ORR, median CNS-PFS, and OS of 4/30 (13.3%), 2.9 months (95%CI: 2.0 - 4.3), and 6.9 months (95%CI: 3.1-10.2), respectively. However, we did not observe any centrally-confirmed CNS responses in the seven patients with active BM. Furthermore, both patients with stable BM and CNS response after SG also received RT less than two months before the start of OS. Responding lesions were irradiated. This is the largest cohort of patients treated per current real-world practice, including CNS metastases data in MBC patients. Results align with a retrospective cohort of five patients with active CNS metastases, showing a median CNS-PFS of 2.7 months (95% CI 1.9–10.5) and a disease control rate of 42% (95% CI 13%–71%) 12 . We observed some efficacy of SG in pretreated patients with leptomeningeal involvement, with CNS-ORR, disease control rate (DCR), median CNS-PFS, and OS of 28.6%, 71.4%, 2.1 months (95%CI 0.4-7.7), and 3.8 months (95%CI 1.7-11.9), respectively. Although these results are still poor, they should be interpreted in the context of the known dismal outcome of patients with HER2-negative MBC, with an expected survival from the diagnosis of LMD of 3.7–6.0 months for HR+/HER2- and 2.0–3.0 months for TNBC 13 . Our results are comparable with the prospective data from the ASCENT trial, which included 32 patients with stable/treated BM TNBC randomized to SG. In this subgroup analysis, the median non-CNS-PFS and OS were 2.8 months (95%CI: 1.5–3.9) and 7.0 months (95%CI: 4.7–14.7), and the non-CNS-ORR was 3% 14 . Conversely, the performance of SG in our cohort was inferior to what reported from the overall population (CNS and non-CNS) of the TROPICS-02 study in HR+/HER2- patients: median non-CNS-PFS and OS of 5.5 months (95%CI, 4.2 - 7.0) and 14.4 months (95%CI 13.0–15.7) with a non-CNS-ORR of 21% 15 . Finally, the intracerebral response rates in our cohort were lower than those observed in the phase 0 study by Balinda et al, which reported a response rate of 50% (37% stable disease, 25% partial response, 25% complete response) 9 . This study included patients with all subtypes of MBC eligible for BM resection, unlike our cohort of heavily pretreated TNBC and HR+/HER2- patients. The ongoing Phase II Southwest Oncology Group (SWOG) trial is expected to provide prospective data on the intracerebral efficacy of SG in patients with TNBC (NCT04647916). Our study has several limitations related to the small sample size and the retrospective nature. However, our results are comparable with data from prospective studies, and an independent review of responses reduces the risk of information bias. We did not perform a multivariate analysis due to the small sample size, but CNS involvement is a recognized poor prognostic factor. Finally, our study does not include comprehensive safety data or symptoms, particularly neurological ones, as there was incomplete data on retrospective chart abstraction. In conclusion, we report modest activity of SG in pretreated patients with active and stable/treated CNS metastases and possible activity in patients with LMD. Additionally, the efficacy of CNS and systemic metastatic involvement is comparable. Methods Study objective(s), design, data sources and variables The objective of our study was to evaluate the activity of SG in patients with CNS metastases, considering whether the metastases were active or treated/stable, and LMD, using the RANO response assessment criteria for brain metastases and LMD. We conducted a retrospective, observational, real-world, single-center study using the prospectively maintained institutional EMBRACE database of patients with MBC (DF/HCC IRB #09-204) supplemented by a manual review of the EHRs. We followed and used the checklist of ESMO-GROW recommendations for real-world evidence studies in Oncology 16 . The selection criteria included patients with CNS metastases who had received at least one dose of SG between 2018 and 2022 as part of their routine clinical care. Patient enrolled in clinical trials of SG were excluded. Demographic, clinical, pathological, and treatment data were extracted from the prospectively maintained institutional database. The types of CNS metastases, responses, PFS, and information on neurological deaths were extracted from the EHRs. The subtypes were chosen according to the immunohistochemistry results of the last biopsy before the initiation of SG. Patients with stable/treated BM were defined as having previously received CNS-specific treatment, and their CNS disease was stable at the evaluation before the initiation of SG. Patients with active BM were defined as those exhibiting new or progressive CNS metastases that had not been treated with CNS-directed therapy since documented progression. LMD was defined as patients having metastases in the leptomeningeal space with or without BM 4 . Response assessment was divided into response rate, stable disease rate, and progressive disease rate in the CNS and non-CNS according to RECIST1.1 17 . An independent neuro-radiologist confirmed CNS-ORR using RANO criteria. Statistical analysis methods Quantitative variables were described using median and range (min; max). Qualitative variables were described using frequency, percentage. Survival endpoints and follow-up were described using the reverse Kaplan-Meier method and reported with a 95% confidence interval. Comparison used Log-rank (Mantel-Cox) test. PFS (CNS, non-CNS, and bicompartmental) were defined as the time from initiation of SG to disease progression (CNS, non-CNS or either) or death from any cause. Overall survival is defined as the time from initiation of SG to death from any cause. The software GraphPad Prism V10 and R Studio were used to create the figures and perform the statistical analyses. Declarations Data availability The datasets of this study are hosted with a protected password known to the lead authors in a data repository and are not available for open access, given their sensitive nature. The corresponding author, Sarah Sammons, MD ( [email protected] ) may be contacted for potential collaborations upon careful screening of the proposals, to share the data grouped and anonymized, provided IRB approval and a data use agreement. Code availability Not applicable to this study Acknowledgments We deeply thank all patients who participate in EMBRACE study for granting access to their data and allowing this work. The first author would like to thank Lucile Cabanel for her unfailing help. Author contributions T.G., S.M., S.M.T, S.S., and N.L. conceived of the presented idea. L.H, A.A, A.G, J.P, S.T, S.S., and N.L. cared for presented patients. R.K. and M.H. did data management T.G. and T-K.Y. performed the statistical analysis. L.H. performed central neuroradiology reads. All authors contributed to the final manuscript. Competing Interests (Mandatory, you should declare all financial and non-financial competing interests for each author. If there are no competing interests to declare, this should be stated) TG discloses Travel fees from AstraZeneca, Gilead, and Pfizer. Consulting/Advisor role for AstraZeneca and Cancerologie-pratique. Research funding: Amgen. SM. reports support from AstraZeneca and Menarini/Stemline. AA declares research funding from Varian and NH TherAguix as well as consulting for Novartis and Seagen. AG reported personal fees from Pfizer. JPL received research funding from Kazia Therapeutics, Lilly and AstraZeneca. Consulting from Minerva Biotechnologies. N.U.L. reports institutional research support from Genentech (and Zion Pharmaceutical as part of GNE), Pfizer, Merck, Seattle. Genetics (now Pfizer), Olema Pharmaceuticals, and AstraZeneca ; consulting honoraria from Puma, Seattle Genetics, Daiichi-Sankyo, AstraZeneca, Olema Pharmaceuticals, Janssen, Blueprint Medicines, Stemline/Menarini, Artera Inc., and Eisai; royalties from UpToDate; and travel support from Olema Pharmaceuticals. S.M.T. reports consulting/ advisory role Novartis, Pfizer, Merck, Eli Lilly, AstraZeneca, Genentech/ Roche, Eisai, Sanofi, Bristol Myers Squibb, Seattle Genetics, CytomX Therapeutics, Daiichi Sankyo, Gilead, OncXerna, Zymeworks, Zentalis, Blueprint Medicines, Reveal Genomics, ARC Therapeutics, Infinity Therapeutics, Sumitovant Biopharma, Umoja Biopharma, Artios Pharma, Menarini/Stemline, Aadi Bio, Bayer, Incyte Corp, Jazz Pharmaceuticals, Natera, Tango Therapeutics, Systimmune, eFFECTOR, Hengrui USA; research funding from Genentech/Roche, Merck, Exelixis, Pfizer, Lilly, Novartis, Bristol Myers Squibb, Eisai, AstraZeneca, Gilead, NanoString Technologies, Seattle Genetics, and OncoPep; and travel support from Eli, Lilly, Sanofi, and Gilead. SS declares research funding to their institution from Astra Zeneca, Eli Lilly, Relay, SEAGEN and Sermonix; and consulting fees from Foundation Medicine, Astra Zeneca, Daichii Sankyo, Eli Lilly, Pfizer, Incyclix, Relay, Gilead, Sermonix and Novartis. HL, TKY, RK authors declare no conflicts of interest. ACKNOWLEDGMENTS : The first author would like to thank Lucile Cabanel for her unfailing help. References Darlix, A. et al. Impact of breast cancer molecular subtypes on the incidence, kinetics and prognosis of central nervous system metastases in a large multicentre real-life cohort. Br J Cancer 121, 991–1000 (2019). Sammons, S. et al. Abstract PS11-01: Brain metastases in metastatic breast cancer: prevalence per line of treatment and cumulative incidence in a cohort of 18075 real-world patients. Cancer Research 84, PS11-01 (2024). Grinda, T. et al. Evolution of overall survival and receipt of new therapies by subtype among 20 446 metastatic breast cancer patients in the 2008–2017 ESME cohort. ESMO Open 6, (2021). FDA, C. for D. E. and. Cancer Clinical Trial Eligibility Criteria: Brain Metastases. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/cancer-clinical-trial-eligibility-criteria-brain-metastases (2020). Mair, M. J. et al. Understanding the activity of antibody–drug conjugates in primary and secondary brain tumours. Nat Rev Clin Oncol 20, 372–389 (2023). André, F. et al. A Pooled Analysis of Trastuzumab Deruxtecan in Patients With HER2-Positive Metastatic Breast Cancer With Brain Metastases. Annals of Oncology 0, (2024). Krop, I. E. et al. Trastuzumab emtansine (T-DM1) versus lapatinib plus capecitabine in patients with HER2-positive metastatic breast cancer and central nervous system metastases: a retrospective, exploratory analysis in EMILIA†. Annals of Oncology 26, 113–119 (2015). Harbeck, N. et al. Trastuzumab deruxtecan in HER2-positive advanced breast cancer with or without brain metastases: a phase 3b/4 trial. Nat Med 1–10 (2024) doi: 10.1038/s41591-024-03261-7 . Balinda, H. U. et al. Sacituzumab Govitecan in patients with breast cancer brain metastases and recurrent glioblastoma: a phase 0 window-of-opportunity trial. Nat Commun 15, 6707 (2024). Lin, N. U. et al. Response assessment criteria for brain metastases: proposal from the RANO group. The Lancet Oncology 16, e270–e278 (2015). Chamberlain, M. et al. Leptomeningeal metastases: a RANO proposal for response criteria. Neuro-Oncology 19, 484–492 (2017). Dannehl, D. et al. The efficacy of sacituzumab govitecan and trastuzumab deruxtecan on stable and active brain metastases in metastatic breast cancer patients—a multicenter real-world analysis. ESMO Open 9, (2024). Bartsch, R., Jerzak, K. J., Larrouquere, L., Müller, V. & Rhun, E. L. Pharmacotherapy for leptomeningeal disease in breast cancer. Cancer Treatment Reviews 122, (2024). Hurvitz, S. A. et al. Subgroup analyses from the phase 3 ASCENT study of sacituzumab govitecan in metastatic triple-negative breast cancer. npj Breast Cancer 10, 1–11 (2024). Rugo, H. S. et al. Overall survival with sacituzumab govitecan in hormone receptor-positive and human epidermal growth factor receptor 2-negative metastatic breast cancer (TROPiCS-02): a randomised, open-label, multicentre, phase 3 trial. The Lancet 402, 1423–1433 (2023). Castelo-Branco, L. et al. ESMO Guidance for Reporting Oncology real-World evidence (GROW). ESMO Real World Data and Digital Oncology 1, (2023). Eisenhauer, E. A. et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). European Journal of Cancer 45, 228–247 (2009). Tables Table 1 – Clinicopathological characteristics of patients with prior CNS metastases treated with Sacituzumab Govitecan Patients with prior CNS metastases Overall Population Treated/Stable Active LMD N= 33 %, (min, max) N= 18 %, (min, max) N= 7 %, (min, max) N= 8 %, (min, max) Age at SG start (Median, years) 56.7 51.3-65.7 59.59 (42.9 – 75.1) 59.1 (52.9-72.8) 50.88 (41.4 - 68.3) Tumor Subtype at SG start HR+/HER2- 10 30.3% 3 16.7% 5 71.4% 2 25% TNBC 23 69.7% 15 83.3% 2 28.6% 6 75% Her2 Status at SG start HER2-0 22 66.7% 9 50% 7 100% 6 75% HER2-Low 11 33.3% 9 50% 0 0.0% 2 25% Number of Metastatic Sites at SG start (median) 3 (1- 6) 3 (3 - 5) 4 (2 – 5) 2.5 (2 - 6) Sites involved at Time of SG start Lung 8 24.2% 5 27.8% 2 28.6% 1 12.5% Liver 12 36.4% 6 33.3% 3 42.9% 3 37.5% Bone 21 63.6% 10 55.6% 6 85.7% 5 62.5% Other 22 66.7% 10 55.6% 6 85.7% 6 75% Non-CNS disease status at SG Start Stable / absent 8 24.2% 5 27.8% 2 28.6% 1 12.5% Progressive 25 75.8% 13 72.2% 5 71.4% 7 87.5% Time from MBC to CNS metastases (Median, mo) 11.6 (0.0 - 70.8) 9.9 (0.0 - 70.8) 28.5 (0.0 - 39.5) 5.8 (0.0 - 21.73) Time from MBC to SG Start (Median, mo) 21.5 (1.1 - 138.1) 21.0 (1.1 – 138.1) 37.8 (10.2 – 57.8) 17.3 (7.4 - 24.4) Time from CNS metastases Diagnosis to SG (Median, mo) 7.5 (0.6-94.8) 4.6 (0.7 – 94.8) 9.3 (0.6 – 21.0) 9.3 (2.7 - 21.5) Number of Metastatic Lines Prior to SG (Median) 3 (0 – 10) 3 (0 - 9) 5 (2 -10) 3.5 (2 - 6) Number of Metastatic Lines Prior to CNS metastases (Median) 2 (0 – 9) 1.5 (0 - 9) 4.0 (0 - 5) 1.0 (1- 5) Prior T-DXd Yes 3 9.1% 2 11.1% 1 14.3% 0 0% No 30 90.9% 16 88.9% 6 85.7% 8 100% Prior Surgery for CNS metastases Yes 16 48.5% 9 50% 5 71.4% 2 25% No 17 51.5% 9 50% 2 28.6% 6 75% Prior Radiation for CNS metastases Yes 28 84.8% 17 94.4% 6 85.7% 5 62.5% No 5 15.2% 1 5.6% 1 14.3% 3 37.5% Time from Prior Radiation for CNS metastases to SG (Median, mo) 2.0 0.2 – 44.0 1.0 0.2 – 44.0 7.4 5.0 – 17.5 8.8 1.2 – 15.2 Number of Prior Surgery and/or RT for CNS metastases (median) 1 0 – 3 2 (1 – 3) 2.0 (1 – 3) 1.0 (1 – 2) CNS : central nervous system ; SG: Sacituzumab govitecan ; MBC: metastatic breast cancer ; T-DXd: trastuzumab deruxtecan; RT: radiation therapy Table 2 – CNS and non-CNS response and outcomes to SG RW Response to SG Overall Population Treated/Stable Active LMD CNS response N= 30 %, (IC95%) N= 16 %, (IC95%) N= 7 %, (IC95%) N= 7 %, (IC95%) Response (complete or partial) 4 13.3 2 12.5 0 0.0 2 28.6 Stable disease 16 53.3 10 62.5 3 42.9 3 42.9 Progressive disease 10 33.3 4 25 4 57.1 2 28.6 DCR 20 66.7 12 75 3 42.9 5 71.4 CBR at 6 months 8 26.7 6 37,5 1 14.3 1 14.3 Median CNS-PFS 2.9 (2.0 – 4.3) 3.4 (2.2 – 10.0) 1.9 (1.2 - 16.5) 2.1 (0.4-7.7) Non-CNS response N= 29 N= 15 N= 7 N= 7 Response 1 3.4 0 0 0 0.0 1 14.3 Stable disease 12 41.4 6 40 4 57.1 2 28.6 Progressive disease 16 55.2 9 60 3 42.9 4 57.1 DCR 13 44.8 6 40 4 57.1 3 42.9 CBR at 6 months 4 13.8 2 13.3 1 14.3 1 14.3 Median non-CNS PFS 2.6 (1.9-4.0) 2.7 (1.9-4.2) 1.9 (1.5-10.1) 2.0 (0.4-6.9) Median Bi-compartmental PFS 2.6 (1.9 – 4.0) 2.7 (1.9 - 4.1) 1.8 (1.5 - 10.1) 2.4 (0.4 - 5.1) Overall Survival 6.9 (3.1-10.2) 10.0 (4.3-15.9) 3.1 (1.9-21.6) 3.8 (1.7-11.9) CNS : central nervous system ; SG: Sacituzumab govitecan ; MBC: metastatic breast cancer ; LMD: Leptomeningeal disease; CBR: Clinical Benefit Rate, PFS: progression free survival; DCR : Disease control rate Table 3 – Site of disease progression on SG Overall Population Treated/Stable Active LMD N= 32 % N= 17 % N= 7 % N= 8 % CNS only 1 3.1 0 0 0 0.0 1 12.5 non-CNS only 9 28.1 7 41.2 1 14.3 1 12.5 CNS and non-CNS 17 53.1 7 41.2 4 57.1 6 75.0 Death 5 15.6 3 17.7 2 28.6 0 0.0 CNS : central nervous system ; LMD: Leptomeningeal disease Supplementary Figure Supplementary Figure 1 is not available with this version. Additional Declarations Competing interest reported. TG discloses Travel fees from AstraZeneca, Gilead, and Pfizer. Consulting/Advisor role for AstraZeneca and Cancerologie-pratique. Research funding: Amgen. SM. reports support from AstraZeneca and Menarini/Stemline. AA declares research funding from Varian and NH TherAguix as well as consulting for Novartis and Seagen. AG reported personal fees from Pfizer. JPL received research funding from Kazia Therapeutics, Lilly and AstraZeneca. Consulting from Minerva Biotechnologies. N.U.L. reports institutional research support from Genentech (and Zion Pharmaceutical as part of GNE), Pfizer, Merck, Seattle. Genetics (now Pfizer), Olema Pharmaceuticals, and AstraZeneca ; consulting honoraria from Puma, Seattle Genetics, Daiichi-Sankyo, AstraZeneca, Olema Pharmaceuticals, Janssen, Blueprint Medicines, Stemline/Menarini, Artera Inc., and Eisai; royalties from UpToDate; and travel support from Olema Pharmaceuticals. S.M.T. reports consulting/ advisory role Novartis, Pfizer, Merck, Eli Lilly, AstraZeneca, Genentech/ Roche, Eisai, Sanofi, Bristol Myers Squibb, Seattle Genetics, CytomX Therapeutics, Daiichi Sankyo, Gilead, OncXerna, Zymeworks, Zentalis, Blueprint Medicines, Reveal Genomics, ARC Therapeutics, Infinity Therapeutics, Sumitovant Biopharma, Umoja Biopharma, Artios Pharma, Menarini/Stemline, Aadi Bio, Bayer, Incyte Corp, Jazz Pharmaceuticals, Natera, Tango Therapeutics, Systimmune, eFFECTOR, Hengrui USA; research funding from Genentech/Roche, Merck, Exelixis, Pfizer, Lilly, Novartis, Bristol Myers Squibb, Eisai, AstraZeneca, Gilead, NanoString Technologies, Seattle Genetics, and OncoPep; and travel support from Eli, Lilly, Sanofi, and Gilead. SS declares research funding to their institution from Astra Zeneca, Eli Lilly, Relay, SEAGEN and Sermonix; and consulting fees from Foundation Medicine, Astra Zeneca, Daichii Sankyo, Eli Lilly, Pfizer, Incyclix, Relay, Gilead, Sermonix and Novartis. HL, TKY, RK authors declare no conflicts of interest. Supplementary Files SupplementaryMaterialRWOutcomeswithSacituzumabGovitecanamongBCpatientswithCNSmetastasescopie.docx Supplementary Table 1 - CNS and non-CNS response and outcomes from SG according to subtype Supplementary Table 2 – Site of disease progression on SG according to subtype Cite Share Download PDF Status: Published Journal Publication published 05 Mar, 2025 Read the published version in npj Breast Cancer → Version 1 posted Editorial decision: Revision requested 25 Dec, 2024 Reviews received at journal 20 Dec, 2024 Reviews received at journal 28 Nov, 2024 Reviewers agreed at journal 27 Nov, 2024 Reviewers agreed at journal 08 Nov, 2024 Reviewers invited by journal 06 Nov, 2024 Editor assigned by journal 01 Nov, 2024 Submission checks completed at journal 29 Oct, 2024 First submitted to journal 28 Oct, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5348788","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":375041459,"identity":"3b81f946-7e15-46cd-bdea-5ff6166ad8f8","order_by":0,"name":"Thomas Grinda","email":"data:image/png;base64,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","orcid":"","institution":"Dana-Farber Cancer Institute, Harvard Medical School","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Thomas","middleName":"","lastName":"Grinda","suffix":""},{"id":375041460,"identity":"39e24a26-61ac-4bb2-be87-5906178bda63","order_by":1,"name":"Stefania Morganti","email":"","orcid":"","institution":"Dana-Farber Cancer Institute, Harvard Medical School","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Stefania","middleName":"","lastName":"Morganti","suffix":""},{"id":375041461,"identity":"a6dfa40b-ddf8-4dc1-ac90-aa7b812272cb","order_by":2,"name":"Liangge Hsu","email":"","orcid":"","institution":"Brigham and Women's Hospital, Harvard Medical School","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Liangge","middleName":"","lastName":"Hsu","suffix":""},{"id":375041462,"identity":"7297e02f-514a-4c71-be14-e346da83eb94","order_by":3,"name":"Tae-Kyung Yoo","email":"","orcid":"","institution":"Dana-Farber Cancer Institute, Harvard Medical School","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Tae-Kyung","middleName":"","lastName":"Yoo","suffix":""},{"id":375041463,"identity":"af76850a-4fad-4be1-985a-e92944b8da8f","order_by":4,"name":"Ross J. Kusmick","email":"","orcid":"","institution":"Dana-Farber Cancer Institute, Harvard Medical School","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ross","middleName":"J.","lastName":"Kusmick","suffix":""},{"id":375041464,"identity":"f5d66ec7-2d1f-4f20-bc98-f80a67cdd3df","order_by":5,"name":"Ayal A. Aizer","email":"","orcid":"","institution":"Brigham and Women's Hospital, Harvard Medical School","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ayal","middleName":"A.","lastName":"Aizer","suffix":""},{"id":375041468,"identity":"7d4313e7-6f7c-4501-9df1-e3679cc06523","order_by":6,"name":"Antonio Giordano","email":"","orcid":"","institution":"Dana-Farber Cancer Institute, Harvard Medical School","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Antonio","middleName":"","lastName":"Giordano","suffix":""},{"id":375041469,"identity":"81be2195-348e-4138-89c6-808f04329996","order_by":7,"name":"Jose P. Leone","email":"","orcid":"","institution":"Dana-Farber Cancer Institute, Harvard Medical School","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jose","middleName":"P.","lastName":"Leone","suffix":""},{"id":375041471,"identity":"050b0674-13d7-421c-ad43-de5ee015ea18","order_by":8,"name":"Melissa Hughes","email":"","orcid":"","institution":"Dana-Farber Cancer Institute, Harvard Medical School","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Melissa","middleName":"","lastName":"Hughes","suffix":""},{"id":375041473,"identity":"f5650308-8234-4dc1-9922-089143d631d0","order_by":9,"name":"Sara M. Tolaney","email":"","orcid":"","institution":"Dana-Farber Cancer Institute, Harvard Medical School","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Sara","middleName":"M.","lastName":"Tolaney","suffix":""},{"id":375041474,"identity":"19a5b83c-4277-4338-9f10-cc36544cae08","order_by":10,"name":"Nancy U. Lin","email":"","orcid":"","institution":"Dana-Farber Cancer Institute, Harvard Medical School","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Nancy","middleName":"U.","lastName":"Lin","suffix":""},{"id":375041475,"identity":"81553e96-c9df-49f4-9910-6c9f0ac6e37c","order_by":11,"name":"Sarah L. Sammons","email":"","orcid":"","institution":"Dana-Farber Cancer Institute, Harvard Medical School","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Sarah","middleName":"L.","lastName":"Sammons","suffix":""}],"badges":[],"createdAt":"2024-10-28 16:53:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5348788/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5348788/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41523-025-00736-9","type":"published","date":"2025-03-05T15:58:17+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":69435992,"identity":"10db6e68-22a8-41ba-bd1e-53df365199e4","added_by":"auto","created_at":"2024-11-20 10:34:17","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":17539,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSwimmers plot of CNS PFS, OS, response and neurological death from Sacituzumab Govitecan start according to stable / Active / LMD\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSwimmers plot illustrating Central Nervous system progression free survival (CNS-PFS, colored line) and overall survival (OS, gray line), occurrence of non-CNS progression and death in metastatic breast cancer patients with CNS metastases treated with sacituzumab govitecan. LMD: leptomeningeal disease\u003c/p\u003e","description":"","filename":"Figure1Swminplot11.png","url":"https://assets-eu.researchsquare.com/files/rs-5348788/v1/da59bc1b8f455dce7fdc4f7f.png"},{"id":69435116,"identity":"c08e453a-afd0-46a3-a487-95d0a18762eb","added_by":"auto","created_at":"2024-11-20 10:26:17","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":389032,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eRadiographic responses to CNS metastases of metastatic breast cancer with SG\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBaseline and Central Nervous system (CNS) response assessment by MRI Brain imaging of patients with metastatic breast cancer patients with CNS metastases treated with sacituzumab govitecan. LMD: leptomeningeal disease;BM: Brain Metastases. Patient #11 with stable BM received RT (SRS) less than two months before the initiation of OS. Patient #27 was irradiated for 9 months on another lesion (temporal) and patient #31 did not receive any irradiation before the SG\u003c/p\u003e","description":"","filename":"Figure2111.png","url":"https://assets-eu.researchsquare.com/files/rs-5348788/v1/44e53a04d770129eb2176938.png"},{"id":69435113,"identity":"f15198e2-e083-4218-b5ba-a1eded69af95","added_by":"auto","created_at":"2024-11-20 10:26:17","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":33752,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSurvival outcomes of patients with CNS Metastases treated with SG\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKaplan Meier curve of Central Nervous System progression free survival (CNS-PFS, A) , Bi compartmental PFS and Overall Survival (OS)\u003c/p\u003e","description":"","filename":"Figure3101.png","url":"https://assets-eu.researchsquare.com/files/rs-5348788/v1/80fe01cb48084ed120ba5fd8.png"},{"id":78191389,"identity":"97d782cb-a152-4129-9a4e-32c0588eddfa","added_by":"auto","created_at":"2025-03-10 19:59:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1568008,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5348788/v1/a6c1d10e-1ecc-484c-a32e-11dcf59ec1a3.pdf"},{"id":69435993,"identity":"ad54a8fd-1206-4c43-8875-e01b1f9aa2b6","added_by":"auto","created_at":"2024-11-20 10:34:17","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":26639,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSupplementary Table 1 - CNS and non-CNS response and outcomes from SG according to subtype\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSupplementary Table 2 – Site of disease progression on SG according to subtype\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"SupplementaryMaterialRWOutcomeswithSacituzumabGovitecanamongBCpatientswithCNSmetastasescopie.docx","url":"https://assets-eu.researchsquare.com/files/rs-5348788/v1/66f71ec250dd1c7b5370ead8.docx"}],"financialInterests":"Competing interest reported. TG discloses Travel fees from AstraZeneca, Gilead, and Pfizer. Consulting/Advisor role for AstraZeneca and Cancerologie-pratique. Research funding: Amgen. SM. reports support from AstraZeneca and Menarini/Stemline. AA declares research funding from Varian and NH TherAguix as well as consulting for Novartis and Seagen. AG reported personal fees from Pfizer. JPL received research funding from Kazia Therapeutics, Lilly and AstraZeneca. Consulting from Minerva Biotechnologies. N.U.L. reports institutional research support from Genentech (and Zion Pharmaceutical as part of GNE), Pfizer, Merck, Seattle. Genetics (now Pfizer), Olema Pharmaceuticals, and AstraZeneca ; consulting honoraria from Puma, Seattle Genetics, Daiichi-Sankyo, AstraZeneca, Olema Pharmaceuticals, Janssen, Blueprint Medicines, Stemline/Menarini, Artera Inc., and Eisai; royalties from UpToDate; and travel support from Olema Pharmaceuticals. S.M.T. reports consulting/ advisory role Novartis, Pfizer, Merck, Eli Lilly, AstraZeneca, Genentech/ Roche, Eisai, Sanofi, Bristol Myers Squibb, Seattle Genetics, CytomX Therapeutics, Daiichi Sankyo, Gilead, OncXerna, Zymeworks, Zentalis, Blueprint Medicines, Reveal Genomics, ARC Therapeutics, Infinity Therapeutics, Sumitovant Biopharma, Umoja Biopharma, Artios Pharma, Menarini/Stemline, Aadi Bio, Bayer, Incyte Corp, Jazz Pharmaceuticals, Natera, Tango Therapeutics, Systimmune, eFFECTOR, Hengrui USA; research funding from Genentech/Roche, Merck, Exelixis, Pfizer, Lilly, Novartis, Bristol Myers Squibb, Eisai, AstraZeneca, Gilead, NanoString Technologies, Seattle Genetics, and OncoPep; and travel support from Eli, Lilly, Sanofi, and Gilead. SS declares research funding to their institution from Astra Zeneca, Eli Lilly, Relay, SEAGEN and Sermonix; and consulting fees from Foundation Medicine, Astra Zeneca, Daichii Sankyo, Eli Lilly, Pfizer, Incyclix, Relay, Gilead, Sermonix and Novartis. HL, TKY, RK authors declare no conflicts of interest.","formattedTitle":"Real-World Outcomes with Sacituzumab Govitecan among Breast Cancer patients with Central Nervous System metastases","fulltext":[{"header":"Main text ","content":"\u003cp\u003eCentral nervous system (CNS) metastases, including brain metastases (BM) and leptomeningeal disease (LMD), occur in one-quarter of patients with metastatic breast cancer (MBC), with varying incidence across different subtypes \u003csup\u003e1,2\u003c/sup\u003e. As the overall survival (OS) of patients with MBC is increasing, and the incidence of CNS metastases continues to rise across all tumor subtypes without any signs of plateauing, managing patients with CNS metastases from breast cancer is a major challenge\u003csup\u003e1,3\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eCNS metastases encompass distinct clinical scenarios with specific therapeutic implications and prognosis. The FDA has defined brain metastases based on their clinical status as 1) stable or 2) active. Stable brain metastases refer to patients who have previously received local therapy, such as radiation or resection, and their CNS disease is stable at the time of therapy initiation. Active brain metastases refer to patients with new untreated lesions or previously treated lesions that have not been subjected to CNS-directed therapy since documented progression \u003csup\u003e4\u003c/sup\u003e. There are no FDA-approved systemic therapies that improve progression-free survival (PFS) or OS in patients with active or stable HER2-negative BM. Evaluation of novel agents for these patients is urgently needed.\u003c/p\u003e\n\u003cp\u003eAntibody-drug conjugates (ADCs) are an emerging therapeutic class. Both trastuzumab emtansine and trastuzumab deruxtecan (TDXd) have demonstrated intracranial response improvement in randomized trials of patients with HER2-positive CNS metastases \u003csup\u003e5\u0026ndash;7\u003c/sup\u003e. The Phase 3b/4 DESTINY-Breast study12 evaluated T-DXd in patients with HER2+ breast cancer, including those with active or stable BM (n=263). These patients had an objective response rate in the CNS (ORR-CNS) and a 12-month CNS progression-free survival (CNS-PFS) rate of 79.2% (95%CI 70.2-88.3) and 57.8% (95%CI 48.2-66.1) for patients with stable BM and 62.3% (95%CI 50.1-74.5) and 60.1% (95%CI 49.2-69.4) for patients with active BM, respectively \u003csup\u003e8\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Limited data are available for patients with CNS metastases from hormone receptor-positive and triple-negative breast cancer (TNBC) MBC, which represent 45% and 25% of patients with CNS metastases, respectively \u003csup\u003e1\u003c/sup\u003e. Sacituzumab govitecan (SG) is an ADC composed of an anti-TROP2 antibody linked to an active metabolite of irinotecan. SG has demonstrated significant PFS and OS benefit over standard chemotherapy in pretreated patients with TNBC and HR-positive/HER2-negative (HR+/HER2-) MBC \u003csup\u003e6,7\u003c/sup\u003e. However, these trials excluded patients with active CNS metastases or LMD. A Phase 0 study demonstrated that the SG payload achieved therapeutic levels in brain metastases and induced intracerebral responses with ORR-CNS of 50% in 13 patients with MBC of all subtype \u003csup\u003e9\u003c/sup\u003e; however, limited data on intracranial outcomes in MBC patients exist.\u003c/p\u003e\n\u003cp\u003eIn this retrospective, observational, real-world data study, we report the activity of SG in patients with HR+/HER2- and TN MBC using a prospectively maintained institutional database of patients with MBC at Dana-Farber Cancer Institute (DFCI) and electronic health records collection. The objective of our study was to evaluate the real-world activity of SG in patients with CNS metastases, considering whether the metastases were active or treated/stable, and LMD, using the RANO response assessment criteria for BM and LMD, with confirmation through central radiologic review \u003csup\u003e10,11\u003c/sup\u003e. Treatment response was retrospectively categorized as objective response, stable disease, and progressive disease in the CNS and non-CNS. An independent radiologist confirmed CNS-ORR using RANO criteria \u003csup\u003e10\u003c/sup\u003e. Because clinical status was not uniformly available at each restaging, we used a modified version of the RANO criteria where clinical status was not included in the response assessment.\u003c/p\u003e\n\u003cp\u003eThirty-three patients were included (Table 1), with 18 (54.5%) having treated/stable, 7 (21.2%) having active CNS metastases, and 8 (24.3%) having LMD. Ten (30.3%) and 14 (42.4%) were HR+/HER2- and TNBC, respectively. The median age at SG initiation was 56.7 years. Only one patient had CNS metastasis with no extra-CNS involvement; while 18/33 (54.5%) patients had at least pulmonary and/or hepatic involvement, with a median of 3 (range, 1-6) metastatic sites at SG initiation. Patients were heavily pretreated, with a median of 3 (0-10) lines of therapy in the metastatic setting before SG initiation, and three patients received prior TDXd. In patients with stable brain metastases, the median time from prior CNS-directed radiotherapy to SG start was 2.3 months (range 0.5-44.0). Among patients with LMD, 7/8 had associated BM, and all patients had extra CNS metastases. Two had a positive cerebrospinal fluid (CSF), one had a negative CSF, and five did not have a lumbar puncture. The median follow-up for the entire cohort was 6.7 months (IC95% 3.1\u0026ndash;10.0).\u003c/p\u003e\n\u003cp\u003eThirty (90.9%) and 29 (87.9%) patients had evaluable responses in the CNS and non-CNS, respectively, with a time interval between initiation of SG and first imaging restaging of 1.6 months (95%CI 1.4-2.3) for CNS responses and 2.1 months (95%CI: 1.8-2.6) for non-CNS responses. The CNS-ORR was 12.5% for patients with treated/stable BM, 0% for patients with active BM; 11.1% for HR+/HER2-, and 14.3% for TNBC (Table 2, Figure 2 and Supplementary Table 1). Moreover, no cases of non-CNS objective response (non-CNS-ORR) were observed in patients with treated/stable and active BM. The CNS clinical benefit rate (CNS-CBR: response + stable disease \u0026ge;6 months) was 37.5% and 14.3% for patients with treated/stable and active BM, respectively. 7/8 patients with LMD were evaluable for response according to RANO-LM criteria\u003csup\u003e11\u003c/sup\u003e. \u0026nbsp;For them, the CNS-ORR and CNS-CBR were 28.6% and 14.3%, respectively.\u003c/p\u003e\n\u003cp\u003eThe median CNS-PFS was similar not between patients with stable BM (3.4 mo; 95%CI: 2.2-10.0), patients with active BM (1.9 months; [95%CI: 1.2-16.5]), and those with LMD (2.1 months; [95%CI: 0.4-7.7]) (Figure 3). Additionally, the CNS-PFS of patients with HR+/HER2- and TNBC were similar (2.0 months; [95%CI: 1.2-7.7] and 3.2 months; [95%CI: 2.2-5.1], respectively) (Supplementary Figure 1). The median OS in the population was 6.9 mo (95%CI: 3.1-10.2). OS did not differ significantly between patients with stable BM (10.0 months; [95%CI: 4.3-15.9]) and those with active BM (3.1 months; [95%CI: 1.9-21.6]; \u003cem\u003ep\u003c/em\u003e=0.17) but was longer in patients with stable BM compared to those with LMD (3.8 months; [95% CI: 1.7-11.9]) (Figure 3). A total of 32 patients discontinued SG due to progression, and one patient due to toxicity. Most patients (53.1%) experienced both CNS and extra-CNS disease progression. Out of the five patients who died while receiving SG, two suffered from neurological death (Table 3).\u003c/p\u003e\n\u003cp\u003eIn our cohort of 33 patients with MBC with CNS metastases, SG demonstrated modest CNS and non-CNS activity with a CNS-ORR, median CNS-PFS, and OS of 4/30 (13.3%), 2.9 months (95%CI: 2.0 - 4.3), and 6.9 months (95%CI: 3.1-10.2), respectively. However, we did not observe any centrally-confirmed CNS responses in the seven patients with active BM. Furthermore, both patients with stable BM and CNS response after SG also received RT less than two months before the start of OS. Responding lesions were irradiated.\u003c/p\u003e\n\u003cp\u003eThis is the largest cohort of patients treated per current real-world practice, including CNS metastases data in MBC patients. Results align with a retrospective cohort of five patients with active CNS metastases, showing a median CNS-PFS of 2.7 months (95% CI 1.9\u0026ndash;10.5) and a disease control rate of 42% (95% CI 13%\u0026ndash;71%) \u003csup\u003e12\u003c/sup\u003e. We observed some efficacy of SG in pretreated patients with leptomeningeal involvement, with CNS-ORR, disease control rate (DCR), median CNS-PFS, and OS of 28.6%, 71.4%, 2.1 months (95%CI 0.4-7.7), and 3.8 months (95%CI 1.7-11.9), respectively. Although these results are still \u0026nbsp; poor, they should be interpreted in the context of the known dismal outcome of patients with HER2-negative MBC, with an expected survival from the diagnosis of LMD of 3.7\u0026ndash;6.0 months for HR+/HER2- and 2.0\u0026ndash;3.0 months for TNBC\u003csup\u003e13\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eOur results are comparable with the prospective data from the ASCENT trial, which included 32 patients with stable/treated BM TNBC randomized to SG. In this subgroup analysis, the median non-CNS-PFS and OS were 2.8 months (95%CI: 1.5\u0026ndash;3.9) and 7.0 months (95%CI: 4.7\u0026ndash;14.7), and the non-CNS-ORR was 3%\u003csup\u003e14\u003c/sup\u003e. Conversely, the performance of SG in our cohort was inferior to what reported from the overall population (CNS and non-CNS) of the TROPICS-02 study in HR+/HER2- patients: median non-CNS-PFS and OS of 5.5 months (95%CI, 4.2 - 7.0) and 14.4 months (95%CI 13.0\u0026ndash;15.7) with a non-CNS-ORR of 21% \u003csup\u003e15\u003c/sup\u003e. Finally, the intracerebral response rates in our cohort were lower than those observed in the phase 0 study by Balinda et al, which reported a response rate of 50% (37% stable disease, 25% partial response, 25% complete response) \u003csup\u003e9\u003c/sup\u003e. This study included patients with all subtypes of MBC eligible for BM resection, unlike our cohort of heavily pretreated TNBC and HR+/HER2- patients. The ongoing Phase II Southwest Oncology Group (SWOG) trial is expected to provide prospective data on the intracerebral efficacy of SG in patients with TNBC (NCT04647916).\u003c/p\u003e\n\u003cp\u003eOur study has several limitations related to the small sample size and the retrospective nature. However, our results are comparable with data from prospective studies, and an independent review of responses reduces the risk of information bias. We did not perform a multivariate analysis due to the small sample size, but CNS involvement is a recognized poor prognostic factor. Finally, our study does not include comprehensive safety data or symptoms, particularly neurological ones, as there was incomplete data on retrospective chart abstraction.\u003c/p\u003e\n\u003cp\u003eIn conclusion, we report modest activity of SG in pretreated patients with active and stable/treated CNS metastases and possible activity in patients with LMD. Additionally, the efficacy of CNS and systemic metastatic involvement is comparable.\u003c/p\u003e"},{"header":"Methods","content":"\u003ch3\u003eStudy objective(s), design, data sources and variables\u003c/h3\u003e\n\u003cp\u003eThe objective of our study was to evaluate the activity of SG in patients with CNS metastases, considering whether the metastases were active or treated/stable, and LMD, using the RANO response assessment criteria for brain metastases and LMD.\u003c/p\u003e\n\u003cp\u003eWe conducted a retrospective, observational, real-world, single-center study using the prospectively maintained institutional EMBRACE database of patients with MBC (DF/HCC IRB #09-204) supplemented by a manual review of the EHRs. We followed and used the checklist of ESMO-GROW recommendations for real-world evidence studies in Oncology \u003csup\u003e16\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eThe selection criteria included patients with CNS metastases who had received at least one dose of SG between 2018 and 2022 as part of their routine clinical care. Patient enrolled in clinical trials of SG were excluded. Demographic, clinical, pathological, and treatment data were extracted from the prospectively maintained institutional database. The types of CNS metastases, responses, PFS, and information on neurological deaths were extracted from the EHRs.\u003c/p\u003e\n\u003cp\u003eThe subtypes were chosen according to the immunohistochemistry results of the last biopsy before the initiation of SG. Patients with stable/treated BM were defined as having previously received CNS-specific treatment, and their CNS disease was stable at the evaluation before the initiation of SG. Patients with active BM were defined as those exhibiting new or progressive CNS metastases that had not been treated with CNS-directed therapy since documented progression. LMD was defined as patients having metastases in the leptomeningeal space with or without BM \u003csup\u003e4\u003c/sup\u003e. Response assessment was divided into response rate, stable disease rate, and progressive disease rate in the CNS and non-CNS according to RECIST1.1\u003csup\u003e17\u003c/sup\u003e. An independent neuro-radiologist confirmed CNS-ORR using RANO criteria.\u003c/p\u003e\n\u003ch3\u003eStatistical analysis methods\u003c/h3\u003e\n\u003cp\u003eQuantitative variables were described using median and range (min; max). Qualitative variables were described using frequency, percentage. Survival endpoints and follow-up were described using the reverse Kaplan-Meier method and reported with a 95% confidence interval. Comparison used Log-rank (Mantel-Cox) test. PFS (CNS, non-CNS, and bicompartmental) were defined as the time from initiation of SG to disease progression (CNS, non-CNS or either) or death from any cause. Overall survival is defined as the time from initiation of SG to death from any cause. The software GraphPad Prism V10 and R Studio were used to create the figures and perform the statistical analyses.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eData availability\u003c/h2\u003e\n\u003cp\u003eThe datasets of this study are hosted with a protected password known to the lead authors in a data repository and are not available for open access, given their sensitive nature. The corresponding author, Sarah Sammons, MD ([email protected]) may be contacted for potential collaborations upon careful screening of the proposals, to share the data grouped and anonymized, provided IRB approval and a data use agreement.\u003c/p\u003e\n\u003ch2\u003eCode availability\u003c/h2\u003e\n\u003cp\u003eNot applicable to this study\u003c/p\u003e\n\u003ch2\u003eAcknowledgments\u003c/h2\u003e\n\u003cp\u003eWe deeply thank all patients who participate in EMBRACE study for granting access to their data and allowing this work. The first author would like to thank Lucile Cabanel for her unfailing help.\u003c/p\u003e\n\u003ch2\u003eAuthor contributions\u003c/h2\u003e\n\u003cp\u003eT.G., S.M., S.M.T, S.S., and N.L. conceived of the presented idea.\u003c/p\u003e\n\u003cp\u003eL.H, A.A, A.G, J.P, S.T, S.S., and N.L. cared for presented patients.\u003c/p\u003e\n\u003cp\u003eR.K. and M.H. did data management\u003c/p\u003e\n\u003cp\u003eT.G. and T-K.Y. performed the statistical analysis.\u003c/p\u003e\n\u003cp\u003eL.H. performed central neuroradiology reads.\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e (Mandatory, you should declare all financial and non-financial competing interests for each author. If there are no competing interests to declare, this should be stated)\u003c/p\u003e\n\u003cp\u003eTG discloses Travel fees from AstraZeneca, Gilead, and Pfizer. Consulting/Advisor role for AstraZeneca and Cancerologie-pratique. Research funding: Amgen. SM. reports support from AstraZeneca and Menarini/Stemline. AA declares research funding from Varian and NH TherAguix as well as consulting for Novartis and Seagen. AG reported personal fees from Pfizer. JPL received research funding from Kazia Therapeutics, Lilly and AstraZeneca. Consulting from Minerva Biotechnologies. N.U.L. reports institutional research support from Genentech (and Zion Pharmaceutical as part of GNE), Pfizer, Merck, Seattle. Genetics (now Pfizer), Olema Pharmaceuticals, and AstraZeneca ; consulting honoraria from Puma, Seattle Genetics, Daiichi-Sankyo, AstraZeneca, Olema Pharmaceuticals, Janssen, Blueprint Medicines, Stemline/Menarini, Artera Inc., and Eisai; royalties from UpToDate; and travel support from Olema Pharmaceuticals. S.M.T. reports consulting/ advisory role Novartis, Pfizer, Merck, Eli Lilly, AstraZeneca, Genentech/ Roche, Eisai, Sanofi, Bristol Myers Squibb, Seattle Genetics, CytomX Therapeutics, Daiichi Sankyo, Gilead, OncXerna, Zymeworks, Zentalis, Blueprint Medicines, Reveal Genomics, ARC Therapeutics, Infinity Therapeutics, Sumitovant Biopharma, Umoja Biopharma, Artios Pharma, Menarini/Stemline, Aadi Bio, Bayer, Incyte Corp, Jazz Pharmaceuticals, Natera, Tango Therapeutics, Systimmune, eFFECTOR, Hengrui USA; research funding from Genentech/Roche, Merck, Exelixis, Pfizer, Lilly, Novartis, Bristol Myers Squibb, Eisai, AstraZeneca, Gilead, NanoString Technologies, Seattle Genetics, and OncoPep; and travel support from Eli, Lilly, Sanofi, and Gilead. SS declares research funding to their institution from Astra Zeneca, Eli Lilly, Relay, SEAGEN and Sermonix; and consulting fees from Foundation Medicine, Astra Zeneca, Daichii Sankyo, Eli Lilly, Pfizer, Incyclix, Relay, Gilead, Sermonix and Novartis. HL, TKY, RK authors declare no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eACKNOWLEDGMENTS\u003c/strong\u003e: The first author would like to thank Lucile Cabanel for her unfailing help.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eDarlix, A. et al. Impact of breast cancer molecular subtypes on the incidence, kinetics and prognosis of central nervous system metastases in a large multicentre real-life cohort. Br J Cancer 121, 991\u0026ndash;1000 (2019).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSammons, S. et al. Abstract PS11-01: Brain metastases in metastatic breast cancer: prevalence per line of treatment and cumulative incidence in a cohort of 18075 real-world patients. Cancer Research 84, PS11-01 (2024).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGrinda, T. et al. Evolution of overall survival and receipt of new therapies by subtype among 20 446 metastatic breast cancer patients in the 2008\u0026ndash;2017 ESME cohort. ESMO Open 6, (2021).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFDA, C. for D. E. and. Cancer Clinical Trial Eligibility Criteria: Brain Metastases. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.fda.gov/regulatory-information/search-fda-guidance-documents/cancer-clinical-trial-eligibility-criteria-brain-metastases\u003c/span\u003e\u003cspan address=\"https://www.fda.gov/regulatory-information/search-fda-guidance-documents/cancer-clinical-trial-eligibility-criteria-brain-metastases\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (2020).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMair, M. J. et al. Understanding the activity of antibody\u0026ndash;drug conjugates in primary and secondary brain tumours. Nat Rev Clin Oncol 20, 372\u0026ndash;389 (2023).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAndr\u0026eacute;, F. et al. A Pooled Analysis of Trastuzumab Deruxtecan in Patients With HER2-Positive Metastatic Breast Cancer With Brain Metastases. Annals of Oncology 0, (2024).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKrop, I. E. et al. Trastuzumab emtansine (T-DM1) versus lapatinib plus capecitabine in patients with HER2-positive metastatic breast cancer and central nervous system metastases: a retrospective, exploratory analysis in EMILIA\u0026dagger;. Annals of Oncology 26, 113\u0026ndash;119 (2015).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHarbeck, N. et al. Trastuzumab deruxtecan in HER2-positive advanced breast cancer with or without brain metastases: a phase 3b/4 trial. Nat Med 1\u0026ndash;10 (2024) doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/s41591-024-03261-7\u003c/span\u003e\u003cspan address=\"10.1038/s41591-024-03261-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBalinda, H. U. et al. Sacituzumab Govitecan in patients with breast cancer brain metastases and recurrent glioblastoma: a phase 0 window-of-opportunity trial. Nat Commun 15, 6707 (2024).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLin, N. U. et al. Response assessment criteria for brain metastases: proposal from the RANO group. The Lancet Oncology 16, e270\u0026ndash;e278 (2015).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChamberlain, M. et al. Leptomeningeal metastases: a RANO proposal for response criteria. Neuro-Oncology 19, 484\u0026ndash;492 (2017).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDannehl, D. et al. The efficacy of sacituzumab govitecan and trastuzumab deruxtecan on stable and active brain metastases in metastatic breast cancer patients\u0026mdash;a multicenter real-world analysis. ESMO Open 9, (2024).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBartsch, R., Jerzak, K. J., Larrouquere, L., M\u0026uuml;ller, V. \u0026amp; Rhun, E. L. Pharmacotherapy for leptomeningeal disease in breast cancer. Cancer Treatment Reviews 122, (2024).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHurvitz, S. A. et al. Subgroup analyses from the phase 3 ASCENT study of sacituzumab govitecan in metastatic triple-negative breast cancer. npj Breast Cancer 10, 1\u0026ndash;11 (2024).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRugo, H. S. et al. Overall survival with sacituzumab govitecan in hormone receptor-positive and human epidermal growth factor receptor 2-negative metastatic breast cancer (TROPiCS-02): a randomised, open-label, multicentre, phase 3 trial. The Lancet 402, 1423\u0026ndash;1433 (2023).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCastelo-Branco, L. et al. ESMO Guidance for Reporting Oncology real-World evidence (GROW). ESMO Real World Data and Digital Oncology 1, (2023).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEisenhauer, E. A. et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). European Journal of Cancer 45, 228\u0026ndash;247 (2009).\u003c/span\u003e\u003c/li\u003e \u003c/ol\u003e"},{"header":"Tables","content":"\u003ch3\u003eTable 1 \u0026ndash; Clinicopathological characteristics of patients with prior CNS metastases treated with Sacituzumab Govitecan\u003c/h3\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003ePatients with prior CNS metastases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 16%;\"\u003e\n \u003cp\u003eOverall Population\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003eTreated/Stable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003eActive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003eLMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003eN= 33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e%, (min, max)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003eN= 18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e%, (min, max)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003eN= 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e%, (min, max)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003eN= 8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e%, (min, max)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003e\u0026nbsp;Age at SG start (Median, years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e56.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e51.3-65.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e59.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(42.9 \u0026ndash; 75.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e59.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(52.9-72.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e50.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(41.4 - 68.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003eTumor Subtype at SG start\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eHR+/HER2-\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e30.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e16.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e71.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e25%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eTNBC\u0026nbsp;\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e69.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e83.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e28.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e75%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003eHer2 Status at SG start\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eHER2-0\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e66.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e75%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eHER2-Low\u0026nbsp;\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e33.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e25%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003eNumber of Metastatic Sites at SG start (median)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(1- 6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(3 - 5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(2 \u0026ndash; 5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(2 - 6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003eSites involved at Time of SG start\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eLung\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e24.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e27.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e28.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e12.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eLiver\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e36.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e33.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e42.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e37.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eBone\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e63.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e55.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e85.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e62.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eOther\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e66.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e55.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e85.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e75%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003eNon-CNS disease status at SG Start\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eStable / absent \u0026nbsp;\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e24.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e27.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e28.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e12.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eProgressive\u0026nbsp;\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e75.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e72.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e71.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e87.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003eTime from MBC to CNS metastases\u003c/p\u003e\n \u003cp\u003e(Median, mo)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(0.0 - 70.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e9.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(0.0 - 70.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e28.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(0.0 - 39.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(0.0 - 21.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003eTime from MBC to SG Start\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(Median, mo)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e21.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(1.1 - 138.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e21.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(1.1 \u0026ndash; 138.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e37.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(10.2 \u0026ndash; 57.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e17.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(7.4 - 24.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003eTime from CNS metastases Diagnosis to SG (Median, mo) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(0.6-94.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(0.7 \u0026ndash; 94.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(0.6 \u0026ndash; 21.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(2.7 - 21.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003eNumber of Metastatic Lines Prior to SG (Median)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(0 \u0026ndash; 10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(0 - 9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(2 -10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(2 - 6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003eNumber of Metastatic Lines Prior to CNS metastases (Median)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(0 \u0026ndash; 9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(0 - 9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(0 - 5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(1- 5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003ePrior T-DXd\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eYes\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e9.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e11.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e14.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eNo\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e90.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e88.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e85.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003ePrior Surgery for CNS metastases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eYes\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e48.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e71.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e25%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eNo\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e51.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e28.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e75%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003ePrior Radiation for CNS metastases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eYes\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e84.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e94.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e85.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e62.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eNo\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e15.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e5.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e14.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e37.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003eTime from Prior Radiation for CNS metastases to SG (Median, mo) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e0.2 \u0026ndash; 44.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e0.2 \u0026ndash; 44.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e7.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e5.0 \u0026ndash; 17.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e8.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e1.2 \u0026ndash; 15.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003eNumber of Prior Surgery and/or RT for CNS metastases (median)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e0 \u0026ndash; 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(1 \u0026ndash; 3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(1 \u0026ndash; 3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e(1 \u0026ndash; 2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003eCNS : central nervous system ; SG: Sacituzumab govitecan ; MBC: metastatic breast cancer ; T-DXd: trastuzumab deruxtecan; RT: radiation therapy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eTable 2 \u0026ndash; CNS and non-CNS response and outcomes to SG\u003c/h3\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"95%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRW Response to SG\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 17%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall Population\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTreated/Stable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eActive\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 20%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLMD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCNS response\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003eN= 30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e%, (IC95%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003eN= 16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e%, (IC95%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003eN= 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e%, (IC95%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003eN= 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e%, (IC95%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eResponse (complete or partial)\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e28.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eStable disease\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e53.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e62.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e42.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e42.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eProgressive disease\u0026nbsp;\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e33.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e57.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e28.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eDCR\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e66.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e42.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e71.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eCBR at 6 months\u0026nbsp;\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e26.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e37,5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian CNS-PFS\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e(2.0 \u0026ndash; 4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(2.2 \u0026ndash; 10.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e(1.2 - 16.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e(0.4-7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNon-CNS response\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003eN= 29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003eN= 15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003eN= 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003eN= 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eResponse\u0026nbsp;\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eStable disease\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e41.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e57.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e28.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eProgressive disease\u0026nbsp;\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e55.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e42.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e57.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eDCR\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e44.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e57.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e42.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cul\u003e\n \u003cli\u003eCBR at 6 months\u0026nbsp;\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e13.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian non-CNS PFS\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e(1.9-4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(1.9-4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e(1.5-10.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e(0.4-6.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian Bi-compartmental PFS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e(1.9 \u0026ndash; 4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(1.9 - 4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e(1.5 - 10.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e(0.4 - 5.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 24%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall Survival\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e(3.1-10.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e10.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10%;\"\u003e\n \u003cp\u003e(4.3-15.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e(1.9-21.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7%;\"\u003e\n \u003cp\u003e3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12%;\"\u003e\n \u003cp\u003e(1.7-11.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003eCNS : central nervous system ; SG: Sacituzumab govitecan ; MBC: metastatic breast cancer ; LMD: Leptomeningeal disease; CBR: Clinical Benefit Rate, PFS: progression free survival; DCR : Disease control rate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eTable 3 \u0026ndash; Site of disease progression on SG\u003c/h3\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"87%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 27%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 20%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall Population\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 16%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTreated/Stable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 16%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eActive\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 18%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLMD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9%;\"\u003e\n \u003cp\u003eN= 32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11%;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8%;\"\u003e\n \u003cp\u003eN= 17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8%;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9%;\"\u003e\n \u003cp\u003eN= 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6%;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9%;\"\u003e\n \u003cp\u003eN= 8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8%;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCNS only\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27%;\"\u003e\n \u003cp\u003e\u003cstrong\u003enon-CNS only\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e28.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e41.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCNS and non-CNS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e53.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e41.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e57.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e75.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDeath\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11%;\"\u003e\n \u003cp\u003e15.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e17.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6%;\"\u003e\n \u003cp\u003e28.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003eCNS : central nervous system ; LMD: Leptomeningeal disease\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"Supplementary Figure","content":"\u003cp\u003eSupplementary Figure 1 is not available with this version.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"npj-breast-cancer","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"npjbcancer","sideBox":"Learn more about [npj Breast Cancer](http://www.nature.com/npjbcancer/)","snPcode":"41523","submissionUrl":"https://mts-npjbcancer.nature.com/","title":"npj Breast Cancer","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"NPJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-5348788/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5348788/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Central nervous system (CNS) metastases are associated with poor prognosis in patients with metastatic breast cancer (MBC). In this retrospective study, we investigated the activity of sacituzumab govitecan (SG) in 33 patients with HER2-negative MBC and CNS metastases, including active, stable/treated, and leptomeningeal disease (LMD). SG demonstrated a modest CNS objective response rate of 4/30 (13%) and median CNS-progression-free survival of 2.9 months (95%CI:2.0-4.3) in a heavily pretreated population.","manuscriptTitle":"Real-World Outcomes with Sacituzumab Govitecan among Breast Cancer patients with Central Nervous System metastases","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-20 10:26:12","doi":"10.21203/rs.3.rs-5348788/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-12-25T22:15:08+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-12-20T10:20:57+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-11-28T16:43:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"315477336142857971882039580179645958234","date":"2024-11-27T08:24:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"331730688554417842359105157059472266860","date":"2024-11-08T16:30:35+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-11-06T23:04:35+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-11-01T11:22:56+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-10-29T07:03:12+00:00","index":"","fulltext":""},{"type":"submitted","content":"npj Breast Cancer","date":"2024-10-28T16:40:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"npj-breast-cancer","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"npjbcancer","sideBox":"Learn more about [npj Breast Cancer](http://www.nature.com/npjbcancer/)","snPcode":"41523","submissionUrl":"https://mts-npjbcancer.nature.com/","title":"npj Breast Cancer","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"NPJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d4c0a1b7-472b-4714-b608-a883e6fef770","owner":[],"postedDate":"November 20th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":39922463,"name":"Biological sciences/Cancer/Breast cancer"},{"id":39922464,"name":"Biological sciences/Cancer/Metastases"}],"tags":[],"updatedAt":"2025-03-10T19:59:14+00:00","versionOfRecord":{"articleIdentity":"rs-5348788","link":"https://doi.org/10.1038/s41523-025-00736-9","journal":{"identity":"npj-breast-cancer","isVorOnly":false,"title":"npj Breast Cancer"},"publishedOn":"2025-03-05 15:58:17","publishedOnDateReadable":"March 5th, 2025"},"versionCreatedAt":"2024-11-20 10:26:12","video":"","vorDoi":"10.1038/s41523-025-00736-9","vorDoiUrl":"https://doi.org/10.1038/s41523-025-00736-9","workflowStages":[]},"version":"v1","identity":"rs-5348788","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5348788","identity":"rs-5348788","version":["v1"]},"buildId":"veTbxFhMMB0_faC6-Wkog","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}