Brain Metastases in Lung Cancer With Targetable Mutations: Should We Allow Targeted Treatment in Prognostic Indices?

To the Editor In a recent article,¹ Sperduto and colleagues provided an update to their seminal work developing the Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) for patients with brain metastases.² In addition to the initial factors that formed the DS-GPA for lung cancer—patient age, Karnofsky Performance Status, extracranial metastases, and number of brain metastases—presence of EGFR mutation and ALK rearrangement were found to further characterize a favorable cohort with a median overall survival of almost 4 years after incorporation of molecular markers into the prognostication scheme. These findings contrast with the 14.8-month median survival seen in the most favorable subset from the initial publication.