Beyond an Updated Graded Prognostic Assessment (Breast GPA): A Prognostic Index and Trends in Treatment and Survival in Breast Cancer Brain Metastases From 1985 to Today

Sperduto, Paul W.; Mesko, Shane; Li, Jing; Cagney, Daniel; Aizer, Ayal A.; Lin, Nancy U.; Nesbit, Eric; Kruser, Tim J.; Chan, Jason W.; Braunstein, Steve; Lee, Jessica; Kirkpatrick, John P.; Breen, Will; Brown, Paul D.; Shi, Diana D.; Shih, Helen A.; Soliman, Hany; Sahgal, Arjun; Shanley, Ryan; Sperduto, William; Lou, Emil; Everett, Ashlyn S.; Boggs, Drexell Hunter; Masucci, Laura; Roberge, David; Remick, Jill; Plichta, Kristin A.; Buatti, John M.; Jain, Supriya; Gaspar, Laurie E.; Wu, Cheng‐Chia; Wang, Tony J. C.; Bryant, John; Chuong, Michael D.; Yu, James B.; Chiang, Veronica; Nakano, Toshimichi; Aoyama, Hidefumi; Mehta, Minesh P.

doi:10.1016/j.ijrobp.2020.01.051

Cited by 98 publications

(104 citation statements)

References 47 publications

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“…However, in this study, no improvement in the survival of patients with brain metastases was observed with stereotactic radiation therapy. Due to the unavailability of data, we did not assess the impact of Karnofsky Performance Status (KPS) on SABM, and previous studies have shown that KPS is an important factor affecting the prognosis of BCBM (23,24).…”

Section: Discussionmentioning

confidence: 99%

Analysis of Prognostic Factors Affecting the Brain Metastases Free Survival and Survival After Brain Metastases in Breast Cancer

et al. 2020

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This study aimed to analyze the factors affecting brain metastases free survival (BMFS) and the survival after brain metastases (SABM). The data of 215 patients with breast cancer brain metastases (BCBM) in Sun Yat-sen University Cancer Center from January 2000 to August 2017 were retrospectively analyzed. The clinicopathological features of BCBM were analyzed, and their effects on BMFS and SABM were analyzed by univariate and multivariate COX regression. Finally, it was analyzed whether the receptor status of the brain metastases and the primary lesions were consistent. The median age of the entire cohort was 46 years old. The median BMFS, SABM and overall survival were 31, 9 and 44.2 months, respectively. Clinical stage, molecular subtypes and bone metastasis were independent prognostic factors affecting BMFS. TNM stage IV (HR, 4.99 [95% CI, 2.13-11.7]) and triple negative subtype (HR, 2.06 [95% CI, 1.35-3.14]) was significantly associated with shorter BMFS, but the presence of bone metastases (HR, 0.63 [95% CI, 0.45-0.88]) was a favorable factor for BMFS. Molecular subtypes, resection of BCBM and whole brain radiotherapy (WBRT) were independent factors for SABM. The triple negative subtype (HR, 2.02[95% CI, 1.12-3.64]) was significantly associated with shorter SABM. However, resection of BCBM (HR, 0.31 [95% CI, 0.15-0.65]) and WBRT (HR, 0.57 [95% CI, 0.35-0.93]) were independent factors in improving SABM. The conversion rate of ER was 11.1%, PR was 29.6%, and HER2 was 3.7% between paired breast cancer and brain metastases. BMFS and SABM have different influencing factors. Resection of BCBM and WBRT can significantly improve SABM. The frequency of HER2 status changes between the paired BCBM and the primary lesions is low.

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Section: Discussionmentioning

confidence: 99%

Analysis of Prognostic Factors Affecting the Brain Metastases Free Survival and Survival After Brain Metastases in Breast Cancer

et al. 2020

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“…These indexes do no longer reflect current treatment approaches emphasizing again the necessity for a modern prognostic score. It remains unclear why the u-bGPA could not be successfully validated in our study population although being the latest bGPA scoring tool to date (12). Possibly, this is due to the fact that the prognostic FIGURE 5 | Kaplan-Meier curves for distant cranial control (DCC; n = 90) divided by the breast scoring tool for stereotactic therapy (bSRS) in our patient population (log-rank p = 0.036; concordance index 0.482; 95% CI, 0.359-0.604; p = 0.771) with 1-and 2-year DCC estimates.…”

Section: Discussionmentioning

confidence: 98%

“…These indexes do no longer reflect current treatment approaches emphasizing again the necessity for a modern prognostic score. It remains unclear why the u-bGPA could not be successfully validated in our study population although being the latest bGPA scoring tool to date ( 12 ). Possibly, this is due to the fact that the prognostic factor “presence of extracranial metastases” was reintegrated into the u-bGPA ( Table 1 ), like it was originally used in the old, not breast cancer-specific GPA ( 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…Possibly, this is due to the fact that the prognostic factor “presence of extracranial metastases” was reintegrated into the u-bGPA ( Table 1 ), like it was originally used in the old, not breast cancer-specific GPA ( 3 ). However, for the u-bGPA, Sperduto et al only used the sole status of extracranial metastases without any quantitative measurement of the metastatic burden (e.g., dissemination) ( 12 ). Furthermore, no information on extracranial disease progression was provided, although it was described as an important independent factor for OS prognosis and is therefore also part of our bSRS ( 6 , 15 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…The respective study cohort comprised 1,552 breast cancer patients; however, only 164 of which (11%) received SRS alone (5). Furthermore, Sperduto et al updated their bGPA (u-bGPA) and reintegrated the number of brain metastases and the presence of extracranial metastases (12). Table 1 illustrates an overview including several additional prognostic tools.…”

Section: Background and Purposementioning

confidence: 99%

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Validation of Nine Different Prognostic Grading Indexes for Radiosurgery of Brain Metastases in Breast Cancer Patients and Development of an All-Encompassing Prognostic Tool

et al. 2020

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Brain metastases in patients with salivary duct carcinoma: A retrospective study

Fushimi,

Takahashi,

Kawakita

et al. 2024

Cancer Medicine

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BackgroundSalivary duct carcinoma (SDC) is a high‐grade adenocarcinoma with a 5‐year survival rate of 40%. Although drug therapy has improved patients' prognosis, the impact of brain metastasis (BM) remains poorly understood. We aimed to retrospectively examine the incidence of BM in patients with SDC (n = 464) and develop a tool to estimate their prognoses.MethodsWe retrospectively examined 464 patients with SDC enrolled in a multicenter study. We investigated the incidence of BM, overall survival (OS) rates, and factors affecting prognosis in patients with BM. We also developed an SDC‐graded prognostic assessment (GPA) score for disease prognostication.ResultsSixty‐five (14%) patients had BM. The median OS (mOS) was 13.1 months. On univariate and multivariate analyses, factors such as Eastern Cooperative Oncology Group Performance Status >1, human epidermal growth factor receptor 2‐negative status, and locoregional uncontrolled disease were associated with poor OS. SDC‐GPA scores according to the prognostic factors were 0, 1, 2, and 3 points, and mOS estimates were 50.5, 16.1, 3.9, and 1.2 months, respectively (p < 0.001).ConclusionThe SDC‐GPA score emerged as a useful prognostication tool for patients with BM.

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Beyond an Updated Graded Prognostic Assessment (Breast GPA): A Prognostic Index and Trends in Treatment and Survival in Breast Cancer Brain Metastases From 1985 to Today

Cited by 98 publications

References 47 publications

Analysis of Prognostic Factors Affecting the Brain Metastases Free Survival and Survival After Brain Metastases in Breast Cancer

Analysis of Prognostic Factors Affecting the Brain Metastases Free Survival and Survival After Brain Metastases in Breast Cancer

Validation of Nine Different Prognostic Grading Indexes for Radiosurgery of Brain Metastases in Breast Cancer Patients and Development of an All-Encompassing Prognostic Tool

Brain metastases in patients with salivary duct carcinoma: A retrospective study

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