The Lung-molGPA index is based on the original Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) by incorporating recently reported gene alteration data for non-small cell lung cancer (NSCLC) patients with brain metastases (BM). However, the prognostic prediction value of DS-GPA and Lung-molGPA models remains undetermined, especially in patients with different molecule types.
A total of 1184 NSCLC patients with BM analyses for clinical factors and outcomes were identified at Zhejiang Cancer Hospital, China. All prognostic factors were weighted for significance by hazard ratios. The applicability of DS-GPA and Lung-molGPA were reappraised in NSCLC patients with BM and various genetic profiles. Additionally, a modified Lung-molGPA, was newly developed for mutant NSCLC patients.
The NSCLC patients in the present study had a median survival of 14.0 months from the time of BM diagnosis. Both DS-GPA and Lung-molGPA models could predict the outcomes (P < 0.001), while Lung-molGPA model appeared to exhibit better accurate prediction. Furthermore, Lung-molGPA scores exhibited a discrimination capability in patients with gene variations (3.5-4.0 vs 2.5-3.0 vs 1.5-2.0 vs 0-1.0=62.0 vs 32.0 vs 17.7 vs 3.2 months, P < 0.001). However, no significant difference was reached in wild-type patients (P = 0.133). Regarding the oncogene-positive NSCLC patients with BM, a modified Lung-molGPA index had been established derived from the prognostic factors with the C-index of 0.73 (95% CI: 0.73-0.80) to accurately calculate the survival probability (P < 0.001).
In an era of precision medicine, the Lung-molGPA could precisely predict the prognosis of mutant NSCLC patients with BM, while not working in wild-type patients.
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