Molecular Alterations May ID Survival in NSCLC With Brain Metastases

Significant prognostic factors include four factors from earlier index, plus <i>EGFR</i> and <i>ALK</i> alterations
Significant prognostic factors include four factors from earlier index, plus EGFR and ALK alterations

HealthDay News — An updated index incorporating gene and molecular alterations can predict survival in non-small-cell lung cancer (NSCLC) with brain metastases, according to a study published online November 17 in JAMA Oncology.

Paul W. Sperduto, MD, from Minneapolis Radiation Oncology, and colleagues updated the current Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) for patients with NSCLC and brain metastases by incorporating recently reported gene and molecular alteration data to develop the Lung-molGPA. Data were analyzed for 2,186 patients diagnosed between 2006 and 2014. 

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The researchers note that the original DS-GPA was based on patient age, Karnofsky Performance Status, extracranial metastases, and number of brain metastases identified in 1,833 patients with NSCLC and brain metastases diagnosed between 1985 and 2005. For the updated Lung-molGPA, significant prognostic factors included the original four factors from the DS-GPA and two new factors: EGFR and ALK alterations in patients with adenocarcinoma. The median survival in the cohort was 12 months, and median survival was nearly four years for patients with NSCLC-adenocarcinoma and Lung-molGPA scores of 3.5 to 4.0.

"The updated Lung-molGPA incorporating gene alteration data into the DS-GPA is a user-friendly tool that may facilitate clinical decision making and appropriate stratification of future clinical trials," the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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