The brain-lung immunotherapy prognostic (BLIP) Score: a novel robust tool for prognostication in non-small cell lung cancer patients with brain metastases
Menée à partir de données portant sur 240 patients recevant un traitement par inhibiteur de point de contrôle immunitaire pour un cancer du poumon non à petites cellules avec métastases cérébrales, cette étude évalue la performance d'un système de score basé sur des variables clinicopathologiques (âge au diagnostic, résultats histologiques, nombre de métastases...) pour établir un pronostic
Background : Lung cancer is the leading cause of cancer-related mortality, with brain metastases (BMs) significantly worsening prognosis. While Immune checkpoint inhibitors (ICIs) have transformed treatment for non-small cell lung cancer (NSCLC), robust prognostic tools are still lacking.
Methods : The Brain-Lung Immunotherapy Prognostic (BLIP) score was developed using a retrospective cohort of NSCLC patients with BMs treated with ICIs at Karolinska University Hospital, Sweden. Prognostic factors were identified via univariate and multivariable Cox regression. Internal validation employed bootstrap resampling, penalized Cox regression and ROC analysis. External validation was conducted using an independent cohort from Sotiria Thoracic Diseases Hospital of Athens, Greece.
Results : Of 1844 screened patients, 131 from Karolinska and 109 from Sotiria were included. Key variables were histology, age at BM diagnosis, and number of BMs. The BLIP score stratified patients into “Good” and “Poor” prognosis groups, with median overall survival (OS) of 14.5 and 7 months (hazard ratio [HR]: 0.4; p < 0.0001). External validation confirmed these findings (HR: 0.5; p = 0.0099).
Conclusion : The BLIP score is a validated prognostic tool for NSCLC patients with BMs receiving ICIs. Incorporating clinical factors, it enhances personalized risk stratification.
British Journal of Cancer , article en libre accès, 2026