Purpose: Identi cation of a truly high-risk group of brain metastases (BM) in patients with non-small cell lung cancer (NSCLC) could lead to early interventions and probably better prognosis. The objective of the study was to identify this group by generating a multivariable model with recognized and accessible risk factors.Methods: A retrospective cohort from patients seen at a single center during 2010-2020, was divided into a training (TD) and validation (VD) datasets, associations with BM were measured in the TD with logit, variables signi cantly associated were used to generate a multivariate model. Model´s performance was measured by 10-Fold cross validation of the TD and in the VD with the AUC/C-statistic, Akaike information index, and Press´s Q precision test.Results: From 570 patients with NSCLC with complete records a TD and VD were formed, no signi cant differences were found amid both datasets. Variables associated with BM in the multivariate logit analyses were age [P 0.021, OR 0.97 (95%CI 0.94-0.99)]; male gender [P 0.010, OR 2.44 (95%CI 1.24-4.82)]; mutational status [P 0.03, OR 2.1 (95%CI 1.07-4.12); and carcinoembryonic antigen levels [P 0.002, OR 1.002 (95%CI 1.001 -1.003). BM were diagnosed in 23% of the whole cohort. Strati cation into low, medium, or high-risk groups after simpli cation of the model, displayed a frequency of BM in the VD of 8%, 16% and 40% respectively (P 0.027). Conclusion:A multivariate model comprising age, gender, CEA, and mutation status allowed the identi cation of a truly high-risk group of BM in NSCLC patients.

Purpose of review: This review focus on the findings of recent randomized prospective trials evaluating new therapeutic options for primary central nervous system lymphoma (PCNSL) in first line treatment and on the most promising novel agents. Recent findings: The current standard treatment of newly diagnosed PCNSL has long been depending on high dose methotrexate (HD-MTX) based polychemotherapy followed by whole brain radiotherapy (WBRT). Recent randomized trials have provided evidence that high dose chemotherapy with ASCT is a valuable alternative option to WBRT as consolidation after induction HD-MTX based chemotherapy. For the elderly, cumulative studies confirm that chemotherapy alone as initial treatment is the best approach in this frail population in order to reduce chemoradiation neurotoxicity. If the role of rituximab needs to be further investigated, novel agents such as imids and ibrutinib have showed promising drugs to be incorporated in innovative combination treatment.

Purpose: Identification of a truly high-risk group of brain metastases (BM) in patients with non-small cell lung cancer (NSCLC) could lead to early interventions and probably better prognosis. The objective of the study was to identify this group by generating a multivariable model with recognized and accessible risk factors.Methods: A retrospective cohort from patients seen at a single center during 2010-2020, was divided into a training (TD) and validation (VD) datasets, associations with BM were measured in the TD with logit, variables significantly associated were used to generate a multivariate model. Model´s performance was measured by 10-Fold cross validation of the TD and in the VD with the AUC/C-statistic, Akaike information index, and Press´s Q precision test.Results: From 570 patients with NSCLC with complete records a TD and VD were formed, no significant differences were found amid both datasets. Variables associated with BM in the multivariate logit analyses were age [P 0.021, OR 0.97 (95%CI 0.94-0.99)]; male gender [P 0.010, OR 2.44 (95%CI 1.24-4.82)]; mutational status [P 0.03, OR 2.1 (95%CI 1.07-4.12); and carcinoembryonic antigen levels [P 0.002, OR 1.002 (95%CI 1.001 – 1.003). BM were diagnosed in 23% of the whole cohort. Stratification into low, medium, or high-risk groups after simplification of the model, displayed a frequency of BM in the VD of 8%, 16% and 40% respectively (P 0.027).Conclusion: A multivariate model comprising age, gender, CEA, and mutation status allowed the identification of a truly high-risk group of BM in NSCLC patients.

Introduction: In order to optimize clinical and therapeutic approaches for patients with brain metastasis (BM), prognostic markers need to be widely available and simple to execute. Objective: Considering that a Complete-Blood-Count is usually obtained at the initial routine work-up of almost all oncologic patients, the aim of this study was to determine the utility of the neutrophil-to-lymphocyte-ratio (NLR) and the platelet-to-lymphocyte-ratio (PLR) as prognostic markers for BM. Results: A total of 550 patients with systemic cancer were included. Median age at the time of cancer diagnosis was 49 years and median age at the time of BM was 51 years. Median followup time was 11.2 months. Employing NLR cutoff values at BM diagnosis, patients were divided into groups I to III (I: <3, II: 3-4.49, III: >4.5), and median overall survival (MOS) was calculated for each one (I: 20 months, II: 13.9 months, and III: 7.5 months). Groups divided by a PLR cutoff (I: 250, II: ≥250) also differed in MOS (13.9 vs. 9.3 months). After multivariable analysis, only NLR was a significant independent predictor of MOS [I vs. II: 1.5 Odds Ratio (OR); I vs. III: 1.9 OR], meaning that NLR obtained at the time of BM diagnosis was inversely associated with MOS. Conclusion: The NLR, but not the PLR, is predictive of outcome in cancer patients with BM, therefore, NLR might serve as a complement to the already known prognostic scales.