Association of molecular marker status with graded prognostic assessment of lung cancer with brain metastases
Menée à partir de données portant sur 2 186 patients atteints d'un cancer du poumon non à petites cellules diagnostiqué entre 2006 et 2014 et présentant des métastases cérébrales, cette étude multicentrique évalue la performance d'un nouveau système de score, basé sur les 4 facteurs du système de score " Diagnosis-Specific Graded Prognostic Assessment" (âge des patients, statut de performance Karnofsky, présence de métastases extra-crâniennes, nombre de métastases cérébrales) et sur 2 autres facteurs (présence d'altérations au niveau des gènes EGFR et ALK), pour estimer la survie des patients
Historically, the prognosis for patients with brain metastases was thought to be uniformly poor, which led to a purely palliative approach to treating the many patients diagnosed with this very common neurologic complication of cancer. In addition, brain metastases were previously considered a homogeneous disease, despite the myriad of tumors that could potentially spread to the brain and the observed variability in response to local and systemic therapies. Because physicians believed that the vast majority of patients with brain metastases would have uniformly poor outcomes, they adopted whole-brain radiation therapy (WBRT) as the standard of care: it is easy to administer, widely available, and effective at providing palliation.
JAMA Oncology , commentaire, 2015