Prognostication of Brain-Metastasized Patients Receiving Subsequent Systemic Therapy: A Single-Center Long-Term Follow-Up

Background. Survival of patients with brain metastases (BMs) is poor. It has become clear that targeted therapy has an effect on BMs and patient’ prognosis. The question remains which patients benefit from additional systemic therapy. This assumption was evaluated in a large single-center cohort. Me...

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Main Authors: Tijl Vermassen, Charlotte Van Parijs, Stijn De Keukeleire, Katrien Vandecasteele, Sylvie Rottey
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Current Oncology
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Online Access:https://www.mdpi.com/1718-7729/32/2/74
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author Tijl Vermassen
Charlotte Van Parijs
Stijn De Keukeleire
Katrien Vandecasteele
Sylvie Rottey
author_facet Tijl Vermassen
Charlotte Van Parijs
Stijn De Keukeleire
Katrien Vandecasteele
Sylvie Rottey
author_sort Tijl Vermassen
collection DOAJ
description Background. Survival of patients with brain metastases (BMs) is poor. It has become clear that targeted therapy has an effect on BMs and patient’ prognosis. The question remains which patients benefit from additional systemic therapy. This assumption was evaluated in a large single-center cohort. Methods. Patients consecutively planned to undergo local radiotherapy for their BMs in 2006–2017 were selected (<i>n</i> = 200). Prognosis, using CERENAL, disease-specific graded prognostic assessment (DS-GPA), and Radiation Therapy Oncology Group recursive partitioning analysis (RTOG RPA), was evaluated. Results. Ninety-three (46.5%) patients received at least one additional line of systemic therapy subsequent to the diagnosis of their BMs. The median overall survival (OS) was 6.3 months. Having received subsequent systemic therapy resulted in a more favorable OS (10.4 versus 3.9 months). Interestingly, using dichotomized scores, CERENAL showed prognostic properties in all patients for disease-specific survival on multivariate analysis, whereas RTOG RPA and DS-GPA were not withheld in the model. Lastly, only having a favorable DS-GPA resulted in prolonged progression-free survival for first systemic therapy following BM diagnosis. Conclusions. Receiving subsequent systemic therapy has a profound influence on outcome in patients with BMs, indicating the effect of systemic therapy on BMs. Use of the CERENAL brain prognostic score shows potential for further prognostication of patients with more favorable outcomes.
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spelling doaj-art-d791f06f3afd4b73ac13640b3c91c76e2025-08-20T02:44:52ZengMDPI AGCurrent Oncology1198-00521718-77292025-01-013227410.3390/curroncol32020074Prognostication of Brain-Metastasized Patients Receiving Subsequent Systemic Therapy: A Single-Center Long-Term Follow-UpTijl Vermassen0Charlotte Van Parijs1Stijn De Keukeleire2Katrien Vandecasteele3Sylvie Rottey4Department Medical Oncology, Ghent University Hospital, 9000 Ghent, BelgiumDepartment Medical Oncology, Ghent University Hospital, 9000 Ghent, BelgiumDepartment Medical Oncology, Ghent University Hospital, 9000 Ghent, BelgiumCancer Research Institute Ghent, 9000 Ghent, BelgiumDepartment Medical Oncology, Ghent University Hospital, 9000 Ghent, BelgiumBackground. Survival of patients with brain metastases (BMs) is poor. It has become clear that targeted therapy has an effect on BMs and patient’ prognosis. The question remains which patients benefit from additional systemic therapy. This assumption was evaluated in a large single-center cohort. Methods. Patients consecutively planned to undergo local radiotherapy for their BMs in 2006–2017 were selected (<i>n</i> = 200). Prognosis, using CERENAL, disease-specific graded prognostic assessment (DS-GPA), and Radiation Therapy Oncology Group recursive partitioning analysis (RTOG RPA), was evaluated. Results. Ninety-three (46.5%) patients received at least one additional line of systemic therapy subsequent to the diagnosis of their BMs. The median overall survival (OS) was 6.3 months. Having received subsequent systemic therapy resulted in a more favorable OS (10.4 versus 3.9 months). Interestingly, using dichotomized scores, CERENAL showed prognostic properties in all patients for disease-specific survival on multivariate analysis, whereas RTOG RPA and DS-GPA were not withheld in the model. Lastly, only having a favorable DS-GPA resulted in prolonged progression-free survival for first systemic therapy following BM diagnosis. Conclusions. Receiving subsequent systemic therapy has a profound influence on outcome in patients with BMs, indicating the effect of systemic therapy on BMs. Use of the CERENAL brain prognostic score shows potential for further prognostication of patients with more favorable outcomes.https://www.mdpi.com/1718-7729/32/2/74brain metastasestargeted therapysurvival outcomeprognosisretrospective analysis
spellingShingle Tijl Vermassen
Charlotte Van Parijs
Stijn De Keukeleire
Katrien Vandecasteele
Sylvie Rottey
Prognostication of Brain-Metastasized Patients Receiving Subsequent Systemic Therapy: A Single-Center Long-Term Follow-Up
Current Oncology
brain metastases
targeted therapy
survival outcome
prognosis
retrospective analysis
title Prognostication of Brain-Metastasized Patients Receiving Subsequent Systemic Therapy: A Single-Center Long-Term Follow-Up
title_full Prognostication of Brain-Metastasized Patients Receiving Subsequent Systemic Therapy: A Single-Center Long-Term Follow-Up
title_fullStr Prognostication of Brain-Metastasized Patients Receiving Subsequent Systemic Therapy: A Single-Center Long-Term Follow-Up
title_full_unstemmed Prognostication of Brain-Metastasized Patients Receiving Subsequent Systemic Therapy: A Single-Center Long-Term Follow-Up
title_short Prognostication of Brain-Metastasized Patients Receiving Subsequent Systemic Therapy: A Single-Center Long-Term Follow-Up
title_sort prognostication of brain metastasized patients receiving subsequent systemic therapy a single center long term follow up
topic brain metastases
targeted therapy
survival outcome
prognosis
retrospective analysis
url https://www.mdpi.com/1718-7729/32/2/74
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