Novel tool predicts survival in brain metastasis patients

Blood biomarkers must be integrated when attempting to develop improved scores for predicting survival in patients with brain metastases (BMs), suggests a recent study.

The authors sought to improve the 3-tiered, purely biomarker-based LabBM score, which predicts the survival of patients with BMs, by adding the well-established prognostic factor performance status (PS), and to define its role in comparison with the recently proposed Extracranial-Graded Prognostic Assessment score, which is based on the well-known Diagnosis-specific Graded Prognostic Assessment and two of the same biomarkers.

Two hundred twelve patients, managed with upfront brain irradiation, were included in this retrospective single-institution analysis. Survival was stratified by LabBM and LabPS score, each including serum haemoglobin, platelets, albumin, C-reactive protein, and lactate dehydrogenase (plus PS for the LabPS score). Zero, 0.5, or 1 point was assigned, and the final point sum was calculated. A higher point means shorter survival.

The new LabPS score thoroughly predicted overall survival (median, 12.1 to 0.7 mo; 1-year rate: 52 percent to 0 percent; p=0.0001). However, the group with the poorest prognosis (3 or 3.5 points) was small (4 percent). Furthermore, most patients with comparably short survival had a lower point sum.

Of note, the LabPS score did not outperform the recently proposed Extracranial-Graded Prognostic Assessment score.

“Additional research is needed to improve the tools which predict short survival, because many of these patients continue to go undetected with all available scores,” the authors said.