ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2020
Survival in Patients With Brain Metastases: Summary Report on the Updated Diagnosis-Specific Graded Prognostic Assessment and Definition of the Eligibility Quotient.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 323 papers, 9 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
323 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Pooled it
- [Clinical Practice Guidelines for the Management of Brain Metastases from Non-small Cell Lung Cancer with Actionable Gene Alterations in China (2025 Edition)].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2025Guideline
- Preoperative versus postoperative stereotactic radiosurgery for brain metastases: a systematic review and meta-analysis of comparative studies.Neurosurgical review · 2025Pooled it
- Analysis of prognostic factors and risk prediction in brain metastases: a SEER population-based study.Frontiers in oncology · 2025Pooled it
- 6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7).Breast (Edinburgh, Scotland) · 2024Guideline
- Prediction of the treatment response and local failure of patients with brain metastasis treated with stereotactic radiosurgery using machine learning: A systematic review and meta-analysis.Neurosurgical review · 2024Pooled it
- DEGRO guideline for personalized radiotherapy of brain metastases and leptomeningeal carcinomatosis in patients with breast cancer.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Guideline
- Development and adaptations of the Graded Prognostic Assessment (GPA) scale: a systematic review.Clinical & experimental metastasis · 2023Pooled it
- Overall survival following stereotactic radiosurgery for ten or more brain metastases: a systematic review and meta-analysis.BMC cancer · 2023Pooled it
- Final outcome analysis from the phase II TUXEDO-1 trial of trastuzumab-deruxtecan in HER2-positive breast cancer patients with active brain metastases.Neuro-oncology · 2024Trial
- A Phase II Study of Atezolizumab, Pertuzumab, and High-Dose Trastuzumab for Central Nervous System Metastases in Patients with HER2-Positive Breast Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024Trial
- Evaluating the heterogeneity of hippocampal avoidant whole brain radiotherapy treatment effect: A secondary analysis of NRG CC001.Neuro-oncology · 2024Trial
- Impact of Radionecrosis and Local Recurrence on Overall Survival After Stereotactic Radiosurgery for Brain Metastases.Advances in radiation oncology · 2026Article
- Molecular, histopathological, and clinical risk factors for overall metastatic disease and brain metastases in surgically resected stage I-III lung cancer.Clinical & experimental metastasis · 2026Article
- Recommendations from the Geriatric Oncology Working Group of the Spanish Society of Radiation Oncology for the treatment of elderly patients with radiotherapy.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Stereotactic Radiosurgery for Thalamic Brain Metastases: A Retrospective Analysis and Literature Review.Neurosurgery practice · 2026Article
- Effect of Anatomic Contextual Information on the Performance of a Convolutional Neural Network Tasked With Brain Metastasis Detection.Advances in radiation oncology · 2026Article
- Article
- Longitudinal trends in Gamma Knife radiosurgery utilization across multiple technological generations: A Single-Institution Observational Study.Journal of applied clinical medical physics · 2026Observational
- Brain metastases in lung cancer patients: Correlation between radiologic phenotypes and outcome parameters in neurosurgically treated cohort.The neuroradiology journal · 2026Article
263 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
39 authors.
Funding
Abstract
purposeConventional wisdom has rendered patients with brain metastases ineligible for clinical trials for fear that poor survival could mask the benefit of otherwise promising treatments. Our group previously published the diagnosis-specific Graded Prognostic Assessment (GPA). Updates with larger contemporary cohorts using molecular markers and newly identified prognostic factors have been published. The purposes of this work are to present all the updated indices in a single report to guide treatment choice, stratify research, and define an eligibility quotient to expand eligibility.
methodsA multi-institutional database of 6,984 patients with newly diagnosed brain metastases underwent multivariable analyses of prognostic factors and treatments associated with survival for each primary site. Significant factors were used to define the updated GPA. GPAs of 4.0 and 0.0 correlate with the best and worst prognoses, respectively.
resultsSignificant prognostic factors varied by diagnosis and new prognostic factors were identified. Those factors were incorporated into the updated GPA with robust separation (
conclusionMedian survival varies widely and our ability to estimate survival for patients with brain metastases has improved. The updated GPA (available free at brainmetgpa.com) provides an accurate tool with which to estimate survival, individualize treatment, and stratify clinical trials. Instead of excluding patients with brain metastases, enrollment should be encouraged and those trials should be stratified by the GPA to ensure those trials make appropriate comparisons. Furthermore, we recommend the expansion of eligibility to allow for the enrollment of patients with previously treated brain metastases who have a 50% or greater probability of an additional year of survival (eligibility quotient > 0.50).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.