WCLC 2025 - Posters & ePosters-P1.11.39 The BLIP Score: A Tool for Non-Small Cell Lung Cancer Patients With Brain Metastases

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The BLIP (Brain-Lung Immunotherapy Prognostic) Score is a newly developed and validated tool designed to predict prognosis in patients with advanced non-small cell lung cancer (NSCLC) who have brain metastases (BM) and are treated with immune checkpoint inhibitors (ICIs). Given that brain metastases worsen NSCLC outcomes and existing prognostic methods have become outdated in the ICI treatment era, BLIP aims to provide accurate, personalized survival estimates.<br /><br />This retrospective study utilized cohorts from two centers in Sweden and Greece, including patients with advanced NSCLC with brain metastases who received ICIs. Prognostic factors were identified through univariate and multivariable Cox regression analyses. A point-based scoring system was created via backward stepwise elimination, incorporating key factors: histology (non-squamous type scores 1 point), presence of actionable oncogenic mutations (EGFR, BRAFV600E, MET exon 14 skipping, ALK mutations; 1 point), age at BM diagnosis (≥65 years: 1 point), and number of brain metastases (1–3 lesions: 1 point). Patients scoring 2–4 points were classified as “good prognosis,” with a median overall survival (OS) of 15 months, while 0–1 points indicated “poor prognosis” and OS of 7 months.<br /><br />The BLIP score demonstrated strong model performance with an internal cohort area under the curve (AUC) of 0.87 and validation in an external cohort showing a hazard ratio of 0.49. It is simple to use, clinically actionable, and can assist in guiding patient follow-up, palliative care decisions, and clinical trial design.<br /><br />Future research directions include prospective, multicenter international validation, integration of new biomarkers or radiomic data, and assessment of BLIP’s cost-effectiveness in routine clinical workflows. Overall, the BLIP score represents a significant advancement for personalized prognosis in ICI-treated NSCLC patients with brain metastases.

Asset Subtitle

Marcus Skribek

Meta Tag

Speaker Marcus Skribek

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

BLIP Score

Brain-Lung Immunotherapy Prognostic

non-small cell lung cancer

NSCLC

brain metastases

immune checkpoint inhibitors

prognostic tool

survival prediction

oncogenic mutations

clinical validation