Graded Prognostic Assessment (GPA) for Patients With Lung Cancer and Brain Metastases: Initial Report of the Small Cell Lung Cancer GPA and Update of the Non-Small Cell Lung Cancer GPA Including the Effect of Programmed Death Ligand 1 and Other Prognostic Factors

Sperduto, Paul W.; De, Brian; Li, Jing; Carpenter, David; Kirkpatrick, John P.; Milligan, Michael; Shih, Helen A.; Kütük, Tuğçe; Kotecha, Rupesh; Higaki, Hajime; Otsuka, Manami; Aoyama, Hidefumi; Bourgoin, Malie; Roberge, David; Dajani, Salah; Sachdev, Sean; Gainey, Jordan; Buatti, John M.; Breen, William; Brown, Paul D.; Ni, Lisa; Braunstein, Steve; Gallitto, Matthew; Wang, Tony J. C.; Shanley, Ryan; Lou, Emil; Shiao, Jay C.; Gaspar, Laurie E.; Tanabe, Soichi; Nakano, Toshimichi; An, Yi; Chiang, Veronica; Zeng, Liang; Soliman, Hany; Elhalawani, Hesham; Cagney, Daniel; Thomas, Evan M.; Boggs, Drexell Hunter; Ahluwalia, Manmeet; Mehta, Minesh P.

doi:10.1016/j.ijrobp.2022.03.020

Cited by 52 publications

(56 citation statements)

References 53 publications

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“…The present study aimed at validation of the SCLC GPA in a different geographical region, where management approaches are not necessarily identical to those utilized in the cohort evaluated by Sperduto et al [ 7 ]. Indeed, we found different rates of SRS/surgery utilization (4 and 3% (present) versus 19 and 5% (Sperduto et al), respectively).…”

Section: Discussionmentioning

confidence: 99%

“…For continuous variables, such as age and GPA, univariate Cox regression was employed. The GPA score was calculated as proposed by Sperduto et al [ 7 ]. ( Table 1 ).…”

Section: Methodsmentioning

confidence: 99%

“…Both diagnosis-specific and site-agnostic scores are available to clinicians who would like to avoid mismatch between treatment intensity and achievable outcome [ 2 , 3 , 4 , 5 , 6 ]. As part of this effort, Sperduto et al have updated the graded prognostic assessment (GPA) for lung cancer patients [ 7 ]. For the first time, a separate GPA for small cell lung cancer (SCLC) has been introduced.…”

Section: Introductionmentioning

confidence: 99%

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External Validation of the Graded Prognostic Assessment in Patients with Brain Metastases from Small Cell Lung Cancer

et al. 2022

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Background: Recently, graded prognostic assessment (GPA) for small cell lung cancer (SCLC) patients with brain metastases has been developed. This includes age, performance status, number of brain metastases and presence of extracranial metastases. The aim of the present study was to validate this four-tiered prognostic score in a European cohort of patients. Methods: The retrospective validation study included 180 patients from two centers in Germany and Norway. Results: Median survival from radiological diagnosis of brain metastases was 7 months. The GPA point sum as continuous variable (0–4 points) was significantly associated with survival (p < 0.001). However, no significant survival difference was observed between patients in the two strata with better survival (3.5–4 and 2.5–3 points, respectively). Long-term survival in the poor prognosis group (0–1 points) was better than expected. Conclusion: This study supports the prognostic impact of all four parameters contributing to the GPA. The original way of grouping the parameters and breaking the final strata did not give optimal results in this cohort. Therefore, additional validation databases from different countries should be created and evaluated.

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Section: Discussionmentioning

confidence: 99%

“…For continuous variables, such as age and GPA, univariate Cox regression was employed. The GPA score was calculated as proposed by Sperduto et al [ 7 ]. ( Table 1 ).…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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External Validation of the Graded Prognostic Assessment in Patients with Brain Metastases from Small Cell Lung Cancer

et al. 2022

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“…Thereafter, other prognostic classifications have been published: GPA [ 11 ], disease-specific GPA [ 12 ], lung-mol GPA [ 4 ], updated Lung-GPA [ 13 ], melanoma mol-GPA [ 14 ], GI-GPA [ 15 ], and breast GPA [ 16 ]. Lung-mol GPA was advocated in 2017, 20 years after publication of the RPA classification.…”

Section: Improvement Of Prognosis Of Patients With Brain Metastasesmentioning

confidence: 99%

Single isocenter stereotactic irradiation for multiple brain metastases: current situation and prospects

2022

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The prognosis of patients with brain metastases has dramatically improved, and long-term tumor control and reduction of the risk of late toxicities, including neurocognitive dysfunction, are important for patient quality of life. Stereotactic irradiation for multiple brain metastases, rather than whole-brain radiotherapy, can result in high local control rate with low incidence of neurocognitive deterioration and leukoencephalopathy. Recent advances in radiotherapy devices, treatment-planning systems, and image-guided radiotherapy can realize single isocenter stereotactic irradiation for multiple brain metastases (SI-STI-MBM), in which only one isocenter is sufficient to treat multiple brain metastases simultaneously. SI-STI-MBM has expanded the indications for linear accelerator-based stereotactic irradiation and considerably reduced patient burden. This review summarizes the background, methods, clinical outcomes, and specific consideration points of SI-STI-MBM. In addition, the prospects of SI-STI-MBM are addressed.

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“…We read with great interest the recent publication by Sperduto et al 1 detailing the updated lung graded prognostic assessment (GPA) for non-small cell lung cancer (NSCLC), now also including small cell lung cancer (SCLC) and the prognostic significance of programmed cell death ligand-1 (PD-L1) status. With 20% to 50% of patients with NSCLC or SCLC ultimately developing brain metastases (BM), efforts to better individualize management of these patients are paramount.…”

mentioning

confidence: 99%

The Lung Graded Prognostic Assessment: Continued Evolution of Brain Metastases Prognostication

Oliver

Yu²,

Ahmed³

2022

International Journal of Radiation Oncology*Biology*Physics

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Graded Prognostic Assessment (GPA) for Patients With Lung Cancer and Brain Metastases: Initial Report of the Small Cell Lung Cancer GPA and Update of the Non-Small Cell Lung Cancer GPA Including the Effect of Programmed Death Ligand 1 and Other Prognostic Factors

Cited by 52 publications

References 53 publications

External Validation of the Graded Prognostic Assessment in Patients with Brain Metastases from Small Cell Lung Cancer

External Validation of the Graded Prognostic Assessment in Patients with Brain Metastases from Small Cell Lung Cancer

Single isocenter stereotactic irradiation for multiple brain metastases: current situation and prospects

The Lung Graded Prognostic Assessment: Continued Evolution of Brain Metastases Prognostication

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