Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct;145(1):85-95.
doi: 10.1007/s11060-019-03269-x. Epub 2019 Aug 27.

Prognostic assessment in patients with newly diagnosed small cell lung cancer brain metastases: results from a real-life cohort

Ariane Steindl  1   2 , Franziska Schlieter  1   2 , Thomas Klikovits  2   3 , Elena Leber  1   2 , Brigitte Gatterbauer  2   4 , Josa M Frischer  2   4 , Karin Dieckmann  2   5 , Georg Widhalm  2   4 , Sabine Zöchbauer-Müller  1   2 , Mir Ali Reza Hoda  2   3 , Matthias Preusser  1   2 , Anna S Berghoff  6   7
Affiliations

Prognostic assessment in patients with newly diagnosed small cell lung cancer brain metastases: results from a real-life cohort

Ariane Steindl et al. J Neurooncol. 2019 Oct.

Abstract

Purposes: Brain metastases (BM) are a frequent complication in small cell lung cancer (SCLC), resulting in a reduced survival prognosis. Precise prognostic assessment is an important foundation for treatment decisions and clinical trial planning.

Methods: Patients with newly diagnosed SCLC BM were identified from the Vienna Brain Metastasis Registry and evaluated concerning prognostic factors.

Results: 489 patients (male 62.2%, female 37.8%; median age 61 years) were included. Neurological symptoms were present in 297/489 (60.7%) patients. A- to oligosymptomatic patients (5 vs. 9 months, p = 0.030) as well as patients with synchronous diagnosis of BM and primary tumor (5 vs. 9 months, p = 0.008) presented with improved overall survival (OS) prognosis. RPA (HR 1.66; 95% CI 1.44-1.91; p < 0.001), GPA (HR 1.65; p < 0.001), DS-GPA (HR 1.60; p < 0.001) and LabBM score (HR 1.69; p < 0.001) were statistically significantly associated with OS. In multivariate analysis, DS-GPA (HR 1.59; p < 0.001), neurological deficits (HR 1.26; p = 0.021) and LabBM score (HR 1.57; p < 0.001) presented with statistical independent association with OS.

Conclusion: A- to oligosymptomatic BM as well as synchronous diagnosis of SCLC and BM were associated with improved OS. Established prognostic scores could be validated in this large SCLC BM real-life cohort.

Keywords: Neurological symptom; Prognostic factors; Prognostic scores; SCLC brain metastases; Synchronous diagnosis of BM and primary tumor.

PubMed Disclaimer

Conflict of interest statement

Anna Sophie Berghoff has research support from Daiichi Sankyo and honoraria for lectures, consultation or advisory board participation from Roche Bristol-Myers Squibb, Merck, Daiichi Sankyo as well as travel support from Roche, Amgen and AbbVie. Matthias Preusser has received honoraria for lectures, consultation or advisory board participation from the following for-profit companies: Bayer, Bristol-Myers Squibb, Novartis, Gerson Lehrman Group (GLG), CMC Contrast, GlaxoSmithKline, Mundipharma, Roche, Astra Zeneca, AbbVie, Lilly, Medahead, Daiichi Sankyo, Merck Sharp & Dome. All other authors report no conflicts of interest.

Figures

Fig. 1
Fig. 1
Clinical characteristics during the course of SCLC disease including (a) brain metastatic free survival in extended compared to limited disease SCLC according disease status at SCLC diagnosis (b) patient’s characteristics at BM diagnosis (c) first line treatment at diagnosis of BM (d) end of life disease status (e) overall survival according to synchronous compared to subsequent diagnosis of BM
Fig. 2
Fig. 2
Overall survival according to (a) age at BM diagnosis (b) KPS at BM diagnosis (c) presence of extracranial disease at BM diagnosis (d) number of BM at diagnosis (e) year of BM diagnosis (f) first-line BM treatment approaches
Fig. 3
Fig. 3
Overall survival according to (a) presence of neurological symptoms at BM diagnosis (b) presence of neurological deficits at BM diagnosis (c) RPA classes (d) GPA-classes (e) DS-GPA-classes (f) LabBM score groups
See this image and copyright information in PMC

References

    1. Gavrilovic IT, Posner JB. Brain metastases: epidemiology and pathophysiology. J Neurooncol. 2005;75:5–14. doi: 10.1007/s11060-004-8093-6. - DOI - PubMed
    1. Kromer C, Xu J, Ostrom QT, et al. Estimating the annual frequency of synchronous brain metastasis in the United States 2010–2013: a population-based study. J Neurooncol. 2017;134:55–64. doi: 10.1007/s11060-017-2516-7. - DOI - PubMed
    1. Goncalves PH, Peterson SL, Vigneau FD, et al. Risk of brain metastases in patients with nonmetastatic lung cancer: analysis of the Metropolitan Detroit Surveillance, Epidemiology, and End Results (SEER) data. Cancer. 2016 doi: 10.1002/cncr.30000. - DOI - PMC - PubMed
    1. Soffietti R, Abacioglu U, Baumert B, et al. Diagnosis and treatment of brain metastases from solid tumors: guidelines from the European Association of neuro-oncology (EANO) Neuro Oncol. 2017;19:162–174. doi: 10.1093/neuonc/now241. - DOI - PMC - PubMed
    1. Bachelot T, Romieu G, Campone M, et al. Lapatinib plus capecitabine in patients with previously untreated brain metastases from HER2-positive metastatic breast cancer (LANDSCAPE): a single-group phase 2 study. Lancet Oncol. 2013 doi: 10.1016/S1470-2045(12)70432-1. - DOI - PubMed

MeSH terms

Grants and funding

LinkOut - more resources