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The Graded Prognostic Assessment (GPA) estimates survival for patients with brain metastases. Survival and the factors that predict survival vary by diagnosis and the molecular profile of the patient's tumor.
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The Graded Prognostic Assessment (GPA) estimates survival for patients with brain metastases. Survival and the factors that predict survival vary by diagnosis and the molecular profile of the patient's tumor.

These indices have been developed and updated over the past decade. The results have been published in peer-reviewed medical journals and independently validated. The GPA will help patients and their doctors select appropriate treatment and is also used to stratify clinical trials.

References:

See publications on PubMed

1. Sperduto PW, Mesko S, Li J, et al. Survival in Patients with Brain Metastases: Summary Report on the Updated Diagnosis-Specific Graded Prognostic Assessment and Definition of the Eligibility Quotient. Journal of Clinical Oncology 2020:38;3773-3784. DOI: https://doi.org/10.1200/JCO.20.01255

2. Sperduto PW, Mesko S, Li J, et al. Estrogen, Progesterone and HER2 Receptor Discordance Between Primary Tumor and Brain Metastases in Breast Cancer and Its Effect on Treatment and Survival. Neurooncology 2020

3. Sperduto PW, Mesko S, Li J, et al. Beyond an Updated Graded Prognostic Assessment (Breast GPA): A Prognostic Index and Trends in Treatment and Survival in Breast Cancer Brain Metastases from 1985 to Today. Int J Radiat Oncol, Biol, Phys 2020:107(2);334-343.

4. Sperduto PW, Fang P, Li J, et al. Estimating Survival in Patients with Gastrointestinal Cancers and Brain Metastases: An Update of the Graded Prognostic Assessment for Gastrointestinal Cancers (GI-GPA). Clinical and Translational Radiation Oncology 2019 Sep;18:39-45. http://www.ncbi.nlm.nih.gov/pmc/articles/6612649. Published online 2019 Jun 27. doi: 10.1016/j.ctro.2019.06.007. PMCID: PMC6612649. PMID: 31341974

5. Sperduto PW, Fang P, Li J, et al. Survival and prognostic factors in patients with gastrointestinal cancers and brain metastases; have we made progress. Translational Research, June 2019:208;63-72. https://doi.org/10.1016/j.trsl.2019.02.011

6. Sperduto PW, Deegan BJ, Li J, et al. Estimating Survival for Renal Cell Carcinoma Patients with Brain Metastases: An Update of the Renal Graded Prognostic Assessment (Renal-GPA). Neuro-Oncol. 2018 Nov 12;20(12):1652-1660. doi: 10.1093/neuonc/noy099. PMID: 30418657.

7. Sperduto PW, Deegan BJ, Li J, et al. The Effect of Targeted Therapies on Prognostic Factors, Patterns of Care and Survival in Patients with Renal Cell Carcinoma and Brain Metastases. Int J Radiat Onc Biol Phys 2018; 101(4):845-853.

8. Sperduto PW, Jiang W, Brown PD, et al. Estimating Survival in Melanoma Patients with Brain Metastases: An Update of the Graded Prognostic Assessment for Melanoma Using Molecular Markers (Melanoma-molGPA). Int J Radiat Onc Biol Phys 2017, on-line 10/17/17, print issue 11/15/17.

9. Sperduto PW, Jiang W, Brown PD, et al. The Prognostic Value of BRAF, cKIT and NRAS Mutations in Melanoma Patients with Brain Metastases. Int J Radiat Oncol Biol Phys 2017;98(5):1069-1077.

10. Sperduto PW, Yang TJ, Beal K, et al. Estimating Survival in Patients with Lung Cancer and Brain Metastases: An Update of the Graded Prognostic Assessment for Lung Cancer using Molecular Markers (Lung-molGPA). JAMA Oncology, published online Nov 17, 2016; doi: 10.1001/jamaoncol.2016.3834

11. Sperduto PW, Yang TJ, Beal K, et al. The Effect of Gene Alterations and Tyrosine Kinase Inhibition on Survival and Cause of Death in Patients with Adenocarcinoma of the Lung and Brain Metastases. Int J Radiat Oncol Biol Phys 2016;96(2):406-413.

12. Sperduto PW, Kased N, Roberge D, et al. Effect of tumor subtype on survival and the Graded Prognostic Assessment for patients with breast cancer and brain metastases. Int J Radiat Oncol Biol Phys 2012;82(5):2111-2117.

13. Sperduto PW, Kased N, Roberge D, et al. Summary report on the Graded Prognostic Assessment (GPA): an accurate and facile diagnosis-specific tool to estimate survival, guide treatment and stratify clinical trials for patients with brain metastases. J Clin Onc, 30:419-425, 2012.

14. Sperduto PW, Kased N, Roberge D, et al. The Graded Prognostic Assessment (GPA): A new diagnosis-specific prognostic index for women with breast cancer and brain metastases. Int J Radiat Oncol Biol Phys, 82(5):2111-17, 2012.

15. Sperduto PW, Chao ST, Sneed P, et al. Diagnosis-specific prognostic factors, indices and treatment outcomes for patients with newly-diagnosed brain metastases: a multi-institutional analysis of 4259 patients. Int J Radiat Oncol Biol Phys, 77(3);655-661, 2010.

16. Sperduto PW, Berkey B, Gaspar LE, Mehta M, Curran WJ. A new prognostic index and comparison to three other indices for patients with brain metastases: An analysis of 1960 patients in the RTOG database. Int J Radiat Oncol Biol Phys 70:510-514, 2008.

The estimated MST (median survival time) from the time of initial treatment of the brain metastases is:
0 months
25th-75th percentile range: 0 - 0 months
Based on the following selected factors:
Based on the above, the EQ (Eligibility Quotient) is:
0%

The Eligibility Quotient (EQ) is the probability of surviving an additional 12 months from today. It is used by researchers to determine eligibility for clinical trials. We recommend patients with an EQ > 50% be enrolled in clinical trials.

All GPA factors (age, KPS, ECM, molecular profile, number of brain mets) should be entered based on the patient's status at the time of diagnosis of the brain metastasis(es), not the current status. If the EQ is reported as N/A, we do not have enough historical data to reliably compute the EQ for this combination of GPA and months since brain met diagnosis.

From which of the following diagnoses does your patient have brain metastases?
Lung Cancer Non-Small Cell and Small Cell
Melanoma
Breast Cancer
Renal Cell Carcinoma
Gastro-intestinal Cancer Any site
Who's using this calculator? Please select the option that most closely describes you.
Patient / Family
Radiation Oncologist
Medical Oncologist
Neurosurgeon
Primary Care Provider
Other Physician
Resident in training
Medical Student
Other
Calculate Eligibility Quotient (Optional)
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