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Validation and comparison of Breast Graded Prognostic Assessment scores in patients with breast cancer and brain metastases

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Abstract

Purpose

Brain metastases (BM) occur in 15–35% of patients with metastatic breast cancer, conferring poor prognosis and impairing quality of life. Clinical scores have been developed to classify patients according to their prognosis. We aimed to check the utility of the Breast Graded Prognostic Assessment (B-GPA) and its modified version (mB-GPA) and compare them in routine clinical practice.

Methods

This is an ambispective study including all patients with breast cancer BM treated in a single cancer comprehensive center. We analyzed the overall survival (OS) from BM diagnosis until death. The Kaplan–Meier method and Cox proportional hazard regression model were used in the analyses. ROC curves were performed to compare both scores.

Results

We included 169 patients; median age was 50 years. HER2-positive and triple negative patients were 33.7% and 20.7%, respectively. At the last follow-up, 90% of the patients had died. Median OS was 12 months (95% confidence interval 8.0–16.0 months). OS was worse in patients with > 3 BM and in patients with triple negative subtype.

Conclusions

In our series, we confirm that B-GPA and mB-GPA scores correlated with prognosis. ROC curves showed that B-GPA and mB-GPA have similar prognostic capabilities, slightly in favor of mB-GPA.

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Data availability

Database encompassing all patient data is saved in the Hospital’s hardware.

Code availability

IBM SPSS version 18 and R software version 3.3.3.

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Funding

This research received no external funding.

Author information

Authors and Affiliations

  1. Medical Oncology Department, Catalan Institute of Oncology, Duran i Reynals Hospital, Av Gran Via de L’Hospitalet, 199-203 L’Hospitalet de Llobregat, 08908, Barcelona, Catalonia, Spain

    C. Fabregat-Franco, A. Stradella, J. Linares, S. Recalde, A. Fernadez, A. C. Venthecourt, C. Falo, S. Vazquez, M. Bergamino, R. Villanueva, S. Pernas & M. J. Gil-Gil

  2. Clinical Research Unit, Catalan Institute of Oncology, Av Gran Via de L’Hospitalet, L’Hospitalet de Llobregat, 08908, Barcelona, Catalonia, Spain

    V. Navarro

  3. Radiotherapy Oncology Department, Catalan Institute of Oncology, Av Gran Via de L’Hospitalet, L’Hospitalet de Llobregat, 08908, Barcelona, Catalonia, Spain

    M. Galdeano

  4. Neuro-Oncology Unit, Catalan Institute of Oncology, Av Gran Via de L’Hospitalet, L’Hospitalet de Llobregat, 08908, Barcelona, Catalonia, Spain

    R. Velasco & M. Simo

Authors
  1. C. Fabregat-Franco
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  2. A. Stradella
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  3. V. Navarro
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Contributions

AS, JL, MG, SR, MB and CF conceived and planned the hypothesis. MG, MS, RV and SP improved the overview of the study. AS, JL, SR, MB and CF planned the study protocol and collected the data VN, AS and CF analyzed the data and presented the results. CF took the lead in writing the manuscript. All authors provided critical feedback and helped shape the research, analysis and writing of the manuscript.

Corresponding author

Correspondence to C. Fabregat-Franco.

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Conflict of interest

MG declares consulting/advisory fees from Pfizer, Eisai, Genomic-Health, Agendia, Daiichi-Sankyo, Novartis, Roche Pharma and Kern and travel/accommodation grants from Daiichi-Sankyo, Kern, Novartis and Pfizer. SP declares consulting/advisory fees from Astra-Zeneca, Daiichi-Sankyo, Novartis, Polyphor and Roche and travel/accommodation grants from Novartis. CFZ declares facilities to congress attendance from Pfizer. RVV declares professional fees from Novartis, Pfizer and Roche. RVF declares professional fees from Novartis, Gilead, Eisai, Esteve and Takeda. The rest of the authors have no conflicts of interest to declare.

Ethical approval

The protocol and the informed consent were approved by the Ethics Committee of University Hospital of Bellvitge (PR189/20). (Appendix 1in ESM).

Consent to participate

Patients included prospectively signed the informed consent approved by ethics committee (Appendix 2in ESM).

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Fabregat-Franco, C., Stradella, A., Navarro, V. et al. Validation and comparison of Breast Graded Prognostic Assessment scores in patients with breast cancer and brain metastases. Clin Transl Oncol 23, 1761–1768 (2021). https://doi.org/10.1007/s12094-021-02577-x

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  • DOI: https://doi.org/10.1007/s12094-021-02577-x

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