TY  - JOUR
A1  - Riecke, Kerstin
A1  - Müller, Volkmar
A1  - Weide, Rudolf
A1  - Schmidt, Marcus
A1  - Park-Simon, Tjoung-Won
A1  - Möbus, Volker
A1  - Mundhenke, Christoph
A1  - Polasik, Arkadius
A1  - Lübbe, Kristina
A1  - Hesse, Tobias
A1  - Laakmann, Elena
A1  - Thill, Marc
A1  - Fasching, Peter Andreas
A1  - Denkert, Carsten
A1  - Fehm, Tanja
A1  - Nekljudova, Valentina
A1  - Rey, Julia
A1  - Loibl, Sibylle
A1  - Witzel, Isabell
T1  - Predicting prognosis of breast cancer patients with brain metastases in the BMBC registry - comparison of three different GPA prognostic scores
T2  - Cancers
N2  - Simple Summary: The incidence of brain metastases from breast cancer is increasing and the treatment is still a major challenge. Several scores have been developed in order to estimate the prognosis of patients with brain metastases by objective criteria. Here, we validated all three published graded-prognostic-assessment (GPA)-scores in a subcohort of 882 breast cancer patients with brain metastases in the Brain Metastases in the German Breast Cancer (BMBC) registry. Although all three available GPA-scores were associated with OS, they all show limitations mainly in predicting short-term (below 3 months) survival but also in long-term (above 12 months) survival. We discuss the test performances of all scores in our work and provide evidence how physicians should use them as a tool to select patients for different treatment options.
Abstract: Several scores have been developed in order to estimate the prognosis of patients with brain metastases (BM) by objective criteria. The aim of this analysis was to validate all three published graded-prognostic-assessment (GPA)-scores in a subcohort of 882 breast cancer (BC) patients with BM in the Brain Metastases in the German Breast Cancer (BMBC) registry. The median age at diagnosis of BM was 57 years. All in all, 22.3% of patients (n = 197) had triple-negative, 33.4% (n = 295) luminal A like, 25.1% (n = 221) luminal B/HER2-enriched like and 19.2% (n = 169) HER2 positive like BC. Age ≥60 years, evidence of extracranial metastases (ECM), higher number of BM, triple-negative subtype and low Karnofsky-Performance-Status (KPS) were all associated with worse overall survival (OS) in univariate analysis (p < 0.001 each). All three GPA-scores were associated with OS. The breast-GPA showed the highest probability of classifying patients with survival above 12 months in the best prognostic group (specificity 68.7% compared with 48.1% for the updated breast-GPA and 21.8% for the original GPA). Sensitivities for predicting 3 months survival were very low for all scores. In this analysis, all GPA-scores showed only moderate diagnostic accuracy in predicting the OS of BC patients with BM.
KW  - brain metastases
KW  - breast cancer
KW  - prognostic scores
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/62153
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-621533
SN  - 2072-6694
VL  - 13
IS  - 4, art. 844
SP  - 1
EP  - 12
PB  - MDPI
CY  - Basel
ER  -