Estimating Survival in Patients with Non-Small-Cell Lung Cancer and Brain Metastases: A Verification of the Graded Prognostic Assessment for Lung Cancer Using Molecular Markers (Lung-molGPA)

Ji Li; Wang Jing; Xiaoyang Zhai; Wenxiao Jia; Hui Zhu; Jinming Yu

doi:10.2147/OTT.S288928

Estimating Survival in Patients with Non-Small-Cell Lung Cancer and Brain Metastases: A Verification of the Graded Prognostic Assessment for Lung Cancer Using Molecular Markers (Lung-molGPA)

Onco Targets Ther. 2021 Mar 2:14:1623-1631. doi: 10.2147/OTT.S288928. eCollection 2021.

Authors

Ji Li^#¹, Wang Jing^#², Xiaoyang Zhai², Wenxiao Jia², Hui Zhu², Jinming Yu¹

Affiliations

¹ Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People's Republic of China.
² Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: A new tool based on clinical characteristics and molecular factors (Lung-molGPA) was developed to predict the survival of patients with non-small-cell lung cancer but was has not been validated. This study aims to validate the feasibility of the Lung-molGPA in NSCLC.

Patients and methods: Patients diagnosed NSCLC between Feb 2012 and July 2018 were retrospectively reviewed and scored using the Lung-molGPA tool to compare clinical outcomes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by Cox regression analyses.

Results: A total of 618 patients (524 adenocarcinoma [ADC], 94 non-adenocarcinoma [non-ADC]) were collected. For all patients, the median survival time (MST) was 33.0 months (33.6 and 28 months in the ADC and non-ADC groups, respectively; p = 0.21). In the ADC group, the MST for patients with a Lung-molGPA score of 3.5 to 4 was more than 4 years, while the MST was only 25 months in patients scoring 0-1, 30.0 months in patients scoring 1.5-2, and 35.0 months for scores of 2.5-3 (p = 0.048). For the non-ADC group, the MST for scores 0-1, 1.5-2, 2.5-3, and 3.5-4 were 12.0, 20.2, 29.0, and 33.0 months, respectively (p = 0.017).

Conclusion: Our findings provided evidence validating the Lung-molGPA score as a useful tool to determine treatment strategies and to predict prognosis. The model is still exploratory and needs to be evaluated further in combination with additional prognostic markers.

Keywords: GPA; NSCLC; brain metastasis; prognosis; survival.

Grants and funding

This research was funded by Innovation Project of Shandong Academy of Medical Science to Jinming Yu, National Natural Science Foundation of China (Grant number 81972862), and Wu Jieping Medical Foundation (Grant number 320675018288).