A New Diagnosis-Specific Survival Score for Patients to be Irradiated for Brain Metastases from Non-small Cell Lung Cancer

Rades, Dirk; Hansen, Heinke C.; Schild, Steven E.

doi:10.1007/s00408-019-00223-6

Cited by 12 publications

(27 citation statements)

References 16 publications

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“…Even trials that help to better define the optimal sequence of brain radiotherapy and systemic TKI therapy are also necessary. One of these is the phase II multiple-arm study ASCEND-7 (NCT02336451 (176)(177)(178). However, following the progress of radiotherapy and the current availability of new drugs, some factors included in these scores may be less prognostic for patients with BMs and oncogene-addicted disease.…”

Section: Discussionmentioning

confidence: 99%

The optional approach of oncogene-addicted non-small cell lung cancer with brain metastases in the new generation targeted therapies era

Spagnuolo

Muto

Monaco

et al. 2019

Transl Lung Cancer Res

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In recent years, the study of the molecular characteristics of non-small cell lung cancer (NSCLC) has highlighted a specific role of some genes that represent important therapeutic targets, including epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), c-ros oncogene 1 (ROS-1) and v-Raf murine sarcoma viral oncogene homolog B1 (BRAF). Patients with oncogene-addicted cancer benefit more from therapy with tyrosine kinase inhibitors (TKIs) than from chemotherapy. The brain is a preferred site for tumor spread in these patients. In addition, given greater control of extracranial disease and prolonged survival, the brain is often the first site of progression. Therefore, there is great interest in therapeutic approaches that optimize the control of intracranial disease associated with systemic drugs that, by penetrating the blood-brain barrier (BBB), may improve local control. On the latter, radiotherapy provides excellent efficacy but following the results of clinical trials with new brain penetrant drugs, the question of how and especially when to perform brain radiotherapy in patients with oncogene-addicted NSCLC remains open. Prospective studies may indicate which patients are most likely to benefit from combined use or in what sequence they will undergo systemic and radiotherapy treatment. Due to the heterogeneity of patients and the introduction of new generation TKIs, a multidisciplinary assessment for the best management of therapies in NSCLC patients with molecular driver alterations and brain metastases (BM) is required.

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Section: Discussionmentioning

confidence: 99%

The optional approach of oncogene-addicted non-small cell lung cancer with brain metastases in the new generation targeted therapies era

Spagnuolo

Muto

Monaco

et al. 2019

Transl Lung Cancer Res

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show abstract

“…We read the article by Rades et al with great interest [1]. We agree that development of a prognostic score for brain metastases of non-small-cell lung cancer [BM-NSCLC] is essential.…”

Section: To the Editormentioning

confidence: 96%

A Prognostic Score for Brain Metastases of Non-small-cell Lung Cancer in the Era of Precision Medicine

Hsu

Chien

2019

Lung

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“…9 Rades et al have established a series of prognostic evaluation systems for BM of lung cancer with radiation. [10][11][12] However, these models ignored the effect of driver gene mutation, a known prognostic factor, on the survival time of NSCLC. Therefore, Chen et al developed an adjusted prognosis analysis (APA) model for evaluating individuals initially diagnosed with NSCLC and BM, and included the following six prognostic factors: KPS, age, smoking history (replaced by epidermal growth factor receptor (EGFR) mutation in APA 2), local treatment of intracranial metastases, EGFR-tyrosine kinase inhibitor (TKI) treatment, and chemotherapy, 8 which seems to be more advantageous than RPA and GPA.…”

Section: Introductionmentioning

confidence: 99%

“…Sperduto et al have developed a diagnosis‐specific prognostic factor index (DS‐GPA) that takes into consideration age, Karnofsky performance status (KPS), extracranial metastases (ECM), and BM numbers 9 . Rades et al have established a series of prognostic evaluation systems for BM of lung cancer with radiation 10–12 . However, these models ignored the effect of driver gene mutation, a known prognostic factor, on the survival time of NSCLC.…”

Section: Introductionmentioning

confidence: 99%

Applicability of the adjusted graded prognostic assessment for lung cancer with brain metastases using molecular markers (Lung‐molGPA) in a Chinese cohort: A retrospective study of multiple institutions

et al. 2020

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Background In this era of precision medicine, prognostic heterogeneity is an important feature of patients with non‐small cell lung cancer (NSCLC) with brain metastases (BM). This multi‐institutional study is aimed to verify the applicability of the adjusted Lung‐molGPA model for NSCLC with BM in a Chinese cohort. Methods This retrospective study included 1903 patients at three hospitals in Southwest China. The performance of the Lung‐molGPA model was compared with that of the adjusted DS‐GPA model in terms of estimating the survival of NSCLC with BM. Results The median OS of this patient cohort was 27.0 months, and the adenocarcinoma survived longer than the non‐adenocarcinoma (28.0 months vs 18.7 months, p < 0.001). The adjusted Lung‐molGPA model was more accurate in predicting survival of adenocarcinoma patients than the adjusted DS‐GPA model (C‐index: 0.615 vs 0.571), and it was not suitable for predicting survival of non‐adenocarcinoma patients ( p = 0.286, 1.5‐2.0 vs 2.5‐3.0; p = 0.410, 2.5‐3.0 vs 3.5‐4.0). Conclusions The adjusted Lung‐molGPA model is better than the DS‐GPA model in predicting the prognosis of adenocarcinoma patients. However, it failed to estimate the prognosis for non‐adenocarcinoma patients.

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A New Diagnosis-Specific Survival Score for Patients to be Irradiated for Brain Metastases from Non-small Cell Lung Cancer

Cited by 12 publications

References 16 publications

The optional approach of oncogene-addicted non-small cell lung cancer with brain metastases in the new generation targeted therapies era

The optional approach of oncogene-addicted non-small cell lung cancer with brain metastases in the new generation targeted therapies era

A Prognostic Score for Brain Metastases of Non-small-cell Lung Cancer in the Era of Precision Medicine

Applicability of the adjusted graded prognostic assessment for lung cancer with brain metastases using molecular markers (Lung‐molGPA) in a Chinese cohort: A retrospective study of multiple institutions

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