Real-world prognostic index for patients with KRAS-mutated NSCLC and brain metastases

Patients with KRAS-mutated non-small cell lung cancer (NSCLC) and brain metastases (BMs) form a heterogeneous population with variable prognosis. There is a need for reliable prognostic biomarkers in this patient group. A retrospective study at Karolinska Institute (Stockholm, Sweden) and the University of Heidelberg (Germany), comprising 220 patients with BMs from KRAS-mutated NSCLC found 6 variables correlated with overall survival from BM diagnosis (BM-OS): presence of primary BM disease, performance status, age, symptomatic CNS disease, extracranial metastases, and number of BMs. These 6 variables were used to design a new KRAS-Brain Prognostic Index (KRAS-BPI). Patients with high-index score showed significantly longer BM-OS compared to intermediate or low-index groups (median BM-OS 30.0 versus 9.0 versus 2.0 months, respectively; p<0.001). The authors conclude that KRAS-BPI enables risk stratification of KRAS-mutated NSCLC patients with BMs.