461P - Validation of a modified lung graded prognostic assessment as a tool for survival in NSCLC patients with brain metastases

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Non-Small-Cell Lung Cancer, Metastatic
Translational Research
Presenter Mian Xie
Citation Annals of Oncology (2016) 27 (suppl_9): ix139-ix156. 10.1093/annonc/mdw594
Authors M. Xie1, J. Zhang2, X. Li1, Y. You1
  • 1Respiratory Medicine, The 1st Affiliated Hospital of Guangzhou Medical University, 510100 - Guangzhou/CN
  • 2Respiratory Medicine, The 1st Affiliated Hospital of Guangzhou Medical University, Guangzhou/CN



Several indices have been developed to predict overall survival (OS) in non-small cell lung cancer (NSCLC) patients with brain metastases, including the lung graded prognostic assessment (lung-GPA), comprising Karnofsky performance score, age, presence of extracranial metastases, and number of brain metastases. However, tumor type is less often incorporated into the final model. We sought to validate the existing lung-GPA in an independent larger cohort and refine it integrating tumor type.


Data were retrospectively gathered from a prospectively maintained institutional database. Patients with newly diagnosed brain metastases from 2005 to 2014 were identified. After validating the lung-GPA, multivariable Cox regression and recursive partitioning analysis led to the development of the modified lung-GPA. The performances of the lung-GPA and modified lung-GPA were compared using the concordance index.


In our cohort of 2890 patients, the lung-GPA was validated as a prognostic tool for OS (P  three v ≤ three), both were independent predictors of OS. We therefore developed the modified lung-GPA integrating a fifth clinical parameter. Recursive partitioning analysis reinforced the prognostic significance of these five factors. Concordance indices were 0.81 (95% CI, 0.78 to 0.84) and 0.85 (95% CI, 0.82 to 0.87) for the lung-GPA and modified lung-GPA, respectively (P 


The modified lung-GPA has prompted additional ongoing efforts to validate the modified lung-GPA in an independent cohort as well as external validation through multi-institutional collaboration and to use it as a patient selection tool for prospective clinical trials.

Clinical trial indentification


Legal entity responsible for the study



Guangzhou Institute of Respiratory Disease


All authors have declared no conflicts of interest.