ALK-Brain Prognostic Index—Preliminary Study of a Prognostic Tool for Patients with ALK-Rearranged, Non-small Cell Lung Cancer and Brain Metastases
Background: Disease-specific Graded Prognostic Assessment (DS-GPA) is the most validated prognostic tool for patients with brain metastasized lung cancer. The Lung-molGPA scoring system was recently introduced for oncogenic-driven brain metastasized lung cancer, but has not yet been validated in coh...
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| Format: | Article |
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MDPI AG
2020-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/7/1804 |
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| author | Georgios Tsakonas Caroline Kamali Luigi De Petris Signe Friesland Rolf Lewensohn Simon Ekman |
| author_facet | Georgios Tsakonas Caroline Kamali Luigi De Petris Signe Friesland Rolf Lewensohn Simon Ekman |
| author_sort | Georgios Tsakonas |
| collection | DOAJ |
| description | Background: Disease-specific Graded Prognostic Assessment (DS-GPA) is the most validated prognostic tool for patients with brain metastasized lung cancer. The Lung-molGPA scoring system was recently introduced for oncogenic-driven brain metastasized lung cancer, but has not yet been validated in cohorts including only ALK-translocated tumors. Methods: We designed a retrospective cohort study consisting of 44 patients with brain metastasized ALK-positive, non-small cell lung cancer (NSCLC) who were treated between January 2009 and November 2019 at Karolinska University Hospital in Stockholm, Sweden. Information about demographics and clinicopathological parameters were collected. Predictors of overall survival (OS) were identified by Cox regression analyses. A bootstrap validation with 1000 samples was performed in order to compare the different prognostic scores. Results: The variables found to independently influence OS in the multivariate analysis, i.e., PS, sex and brain metastases at diagnosis, were used as prognostic variables in our new prognostic index (ALK-BPI). Patients were divided into two prognostic groups. The median OS was 65.7 months for the good prognostic group and 22.7 months for the poor prognostic group (<i>p</i> = 0.0068). In the univariate analysis of the different prognostic scores, ALK-BPI performed better than the others (HR = 3.6; 95% CI: 1.3–9.9). The mean C-statistics of the different prognostic scores were compared to each other, and no significant difference was observed. Conclusion: We propose the ALK-BPI score as a new prognostic tool that can easily be applied for ALK-positive lung cancer patients with brain metastases in daily clinical practice, as it has at least the same prognostic value as Lung-molGPA. |
| first_indexed | 2024-03-10T18:39:28Z |
| format | Article |
| id | doaj.art-62ee4ec0c9b241f7a6c70fb91db33378 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T18:39:28Z |
| publishDate | 2020-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-62ee4ec0c9b241f7a6c70fb91db333782023-11-20T05:56:09ZengMDPI AGCancers2072-66942020-07-01127180410.3390/cancers12071804ALK-Brain Prognostic Index—Preliminary Study of a Prognostic Tool for Patients with ALK-Rearranged, Non-small Cell Lung Cancer and Brain MetastasesGeorgios Tsakonas0Caroline Kamali1Luigi De Petris2Signe Friesland3Rolf Lewensohn4Simon Ekman5Theme Cancer, Medical Unit Head & Neck, Lung and Skin Cancer, Karolinska University Hospital, 17176 Stockholm, SwedenTheme Cancer, Medical Unit Head & Neck, Lung and Skin Cancer, Karolinska University Hospital, 17176 Stockholm, SwedenTheme Cancer, Medical Unit Head & Neck, Lung and Skin Cancer, Karolinska University Hospital, 17176 Stockholm, SwedenTheme Cancer, Medical Unit Head & Neck, Lung and Skin Cancer, Karolinska University Hospital, 17176 Stockholm, SwedenTheme Cancer, Medical Unit Head & Neck, Lung and Skin Cancer, Karolinska University Hospital, 17176 Stockholm, SwedenTheme Cancer, Medical Unit Head & Neck, Lung and Skin Cancer, Karolinska University Hospital, 17176 Stockholm, SwedenBackground: Disease-specific Graded Prognostic Assessment (DS-GPA) is the most validated prognostic tool for patients with brain metastasized lung cancer. The Lung-molGPA scoring system was recently introduced for oncogenic-driven brain metastasized lung cancer, but has not yet been validated in cohorts including only ALK-translocated tumors. Methods: We designed a retrospective cohort study consisting of 44 patients with brain metastasized ALK-positive, non-small cell lung cancer (NSCLC) who were treated between January 2009 and November 2019 at Karolinska University Hospital in Stockholm, Sweden. Information about demographics and clinicopathological parameters were collected. Predictors of overall survival (OS) were identified by Cox regression analyses. A bootstrap validation with 1000 samples was performed in order to compare the different prognostic scores. Results: The variables found to independently influence OS in the multivariate analysis, i.e., PS, sex and brain metastases at diagnosis, were used as prognostic variables in our new prognostic index (ALK-BPI). Patients were divided into two prognostic groups. The median OS was 65.7 months for the good prognostic group and 22.7 months for the poor prognostic group (<i>p</i> = 0.0068). In the univariate analysis of the different prognostic scores, ALK-BPI performed better than the others (HR = 3.6; 95% CI: 1.3–9.9). The mean C-statistics of the different prognostic scores were compared to each other, and no significant difference was observed. Conclusion: We propose the ALK-BPI score as a new prognostic tool that can easily be applied for ALK-positive lung cancer patients with brain metastases in daily clinical practice, as it has at least the same prognostic value as Lung-molGPA.https://www.mdpi.com/2072-6694/12/7/1804ALK translocationbrain metastasesnon-small cell lung cancerprognostic scoreoverall survivalALK-Brain Prognostic Index |
| spellingShingle | Georgios Tsakonas Caroline Kamali Luigi De Petris Signe Friesland Rolf Lewensohn Simon Ekman ALK-Brain Prognostic Index—Preliminary Study of a Prognostic Tool for Patients with ALK-Rearranged, Non-small Cell Lung Cancer and Brain Metastases Cancers ALK translocation brain metastases non-small cell lung cancer prognostic score overall survival ALK-Brain Prognostic Index |
| title | ALK-Brain Prognostic Index—Preliminary Study of a Prognostic Tool for Patients with ALK-Rearranged, Non-small Cell Lung Cancer and Brain Metastases |
| title_full | ALK-Brain Prognostic Index—Preliminary Study of a Prognostic Tool for Patients with ALK-Rearranged, Non-small Cell Lung Cancer and Brain Metastases |
| title_fullStr | ALK-Brain Prognostic Index—Preliminary Study of a Prognostic Tool for Patients with ALK-Rearranged, Non-small Cell Lung Cancer and Brain Metastases |
| title_full_unstemmed | ALK-Brain Prognostic Index—Preliminary Study of a Prognostic Tool for Patients with ALK-Rearranged, Non-small Cell Lung Cancer and Brain Metastases |
| title_short | ALK-Brain Prognostic Index—Preliminary Study of a Prognostic Tool for Patients with ALK-Rearranged, Non-small Cell Lung Cancer and Brain Metastases |
| title_sort | alk brain prognostic index preliminary study of a prognostic tool for patients with alk rearranged non small cell lung cancer and brain metastases |
| topic | ALK translocation brain metastases non-small cell lung cancer prognostic score overall survival ALK-Brain Prognostic Index |
| url | https://www.mdpi.com/2072-6694/12/7/1804 |
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