ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2015
Validation and Development of a Modified Breast Graded Prognostic Assessment As a Tool for Survival in Patients With Breast Cancer and Brain Metastases.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 1 of them a synthesis that pooled it.
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Who cites it
64 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Development and adaptations of the Graded Prognostic Assessment (GPA) scale: a systematic review.Clinical & experimental metastasis · 2023Pooled it
- Treatment With Etirinotecan Pegol for Patients With Metastatic Breast Cancer and Brain Metastases: Final Results From the Phase 3 ATTAIN Randomized Clinical Trial.JAMA oncology · 2022Trial
- Radiotherapeutic management of brain metastases in patients with breast cancer: a narrative review.Translational breast cancer research : a journal focusing on translational research in breast cancer · 2026Review
- Chinese Society of Clinical Oncology breast cancer expert consensus on the diagnosis and treatment of breast cancer brain metastasis (2025).Translational breast cancer research : a journal focusing on translational research in breast cancer · 2026Review
- A nomogram for breast cancer brain metastasis patients after stereotactic radiotherapy.BMC cancer · 2025Article
- Modulating the pace: systemic targeted therapy, brain metastasis velocity, and outcomes after Gamma Knife radiosurgery in breast cancer brain metastases.Journal of neuro-oncology · 2025Article
- Development of a prognostic risk stratification model for HER2-positive breast cancer brain metastasis and its implications in guiding treatment decisions.Scientific reports · 2025Article
- Temporal evolution of breast cancer brain metastases treatments and outcomes.NPJ breast cancer · 2025Article
- Article
- Breast Cancer Brain Metastasis: A Comprehensive Review.JCO oncology practice · 2024Review
- Stereotactic radiosurgery for brain metastases from human epidermal receptor 2 positive breast Cancer: an international, multi-center study.Journal of neuro-oncology · 2024Article
- Article
- A prognostic model for triple-negative breast cancer patients with liver metastasis: A population-based study.Heliyon · 2024Article
- Brain Radiotherapy Combined with Targeted Therapy for HER2-Positive Breast Cancer Patients with Brain Metastases.Breast cancer (Dove Medical Press) · 2024Article
- Investigating tumor immunogenicity in breast cancer: deciphering the tumor immune response to enhance therapeutic approaches.Frontiers in immunology · 2024Review
- Development and external validation of a prediction model for brain metastases in patients with metastatic breast cancer.Journal of cancer research and clinical oncology · 2023Article
- Narrative Review of Multidisciplinary Management of Central Nervous Involvement in Patients with HER2-Positive Metastatic Breast Cancer: Focus on Elderly Patients.Advances in therapy · 2023Review
- Review
- Prognosis prediction and risk factors for triple-negative breast cancer patients with brain metastasis: A population-based study.Cancer medicine · 2023Article
- Prognostic impact of extracranial disease control in HER2+ breast cancer-related brain metastases.British journal of cancer · 2023Article
4 more citing papers are in PubMed but not listed here.
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13 authors.
Funding
Abstract
purposeSeveral indices have been developed to predict overall survival (OS) in patients with breast cancer with brain metastases, including the breast graded prognostic assessment (breast-GPA), comprising age, tumor subtype, and Karnofsky performance score. However, number of brain metastases-a highly relevant clinical variable-is less often incorporated into the final model. We sought to validate the existing breast-GPA in an independent larger cohort and refine it integrating number of brain metastases. PATIENTS AND
methodsData were retrospectively gathered from a prospectively maintained institutional database. Patients with newly diagnosed brain metastases from 1996 to 2013 were identified. After validating the breast-GPA, multivariable Cox regression and recursive partitioning analysis led to the development of the modified breast-GPA. The performances of the breast-GPA and modified breast-GPA were compared using the concordance index.
resultsIn our cohort of 1,552 patients, the breast-GPA was validated as a prognostic tool for OS (P < .001). In multivariable analysis of the breast-GPA and number of brain metastases (> three v ≤ three), both were independent predictors of OS. We therefore developed the modified breast-GPA integrating a fourth clinical parameter. Recursive partitioning analysis reinforced the prognostic significance of these four factors. Concordance indices were 0.78 (95% CI, 0.77 to 0.80) and 0.84 (95% CI, 0.83 to 0.85) for the breast-GPA and modified breast-GPA, respectively (P < .001).
conclusionThe modified breast-GPA incorporates four simple clinical parameters of high prognostic significance. This index has an immediate role in the clinic as a formative part of the clinician's discussion of prognosis and direction of care and as a potential patient selection tool for clinical trials.
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