Logo

OpiCalc

FavoritesSpecialtiesDrugsGuidelinesMost Used

Quick Access

Favorites
Most Used

All Specialties

OpiCalc Logo
Clinical CalculatorsDrugsGuidelines
SpecsDrugsGuides
ALBI Grade (Liver)ASTCT GradingATA Thyroid RiskBCLC 2022 Staging (HCC)BSA (Mosteller)CLL-IPICML ELTS ScoreCNS-IPICTCAE v5.0Calvert FormulaDIPSS-Plus (Myelofibrosis)Deauville ScoreEAU NMIBC RiskECOG Performance StatusELN 2022 Risk (AML)ELN CML MilestonesFIGO 2021 (Ovarian)FIGO 2023 (Endometrial)FLIPI-2Fleischner 2017 GuidelinesFong Clinical Risk ScoreHCT-CI (Sorror Score)HPV/p16 OropharynxIGCCCG Risk (Testicular)IMDC (Heng) CriteriaIMWG Myeloma FrailtyIPSS-M (Molecular MDS)ISUP Grade GroupsKarnofsky Status (KPS)Khorana ScoreLugano ClassificationLung-RADS v2022MIPI-b (Biological)MRD Assessment FrameworkMSI/MMR InterpretationMayo 20/2/20 (SMM)NCCN Prostate RiskNCCN-IPI (DLBCL)NSCLC GPAOncotype DX RecurrenceOpioid EquianalgesicPD-L1 TPS InterpretationPERCIST 2.0PREDICT v3.0Platinum-Free IntervalR2-ISS (Revised 2)RANO 2.0RCB (Residual Cancer Burden)RECIST 1.1ROMA ScoreSAVER ScoreSINS ScoreSLiM-CRAB CriteriaSedlis/Peters CriteriaTNM 8th (Colorectal)TNM 8th Ed (Prognostic)TNM 9th (Nasopharynx)TNM 9th Ed (NSCLC)TNM 9th Ed (SCLC)Tyrer-Cuzick (IBIS v8)WHO 2021 CNS Class.WHO 2022 / ICC 2022 AMLZ0011 EligibilityiRECISTiwCLL 2018 ResponsemRECIST (HCC)mRENAL ScoremrTRG (Rectal MRI)
OpiCalc Logo

OpiCalc

Easy, fast, and private medical tools for clinicians. Always free.

No Login Required
Ready for the Bedside

Resources

About UsEditorial PolicyMedical DisclaimerPrivacy PolicyTerms of UseCookie Policy

Support

Contact Us

Clinical Notice:OpiCalc is not a substitute for professional clinical judgment. Always verify dosages and guidelines.

OpiCalc © 2026

•

All Rights Reserved

NSCLC GPA

NSCLC GPAGraded Prognostic Assessment

Prognostic Calculation

Scoring Components

  • Age (< 50, 50-60, > 60)
  • KPS performance status
  • Number of brain metastases
  • Presence of extracranial metastases
  • Molecular markers (EGFR/ALK)

Awaiting Score

The Graded Prognostic Assessment (GPA) is the most modern tool for estimating survival in patients with brain metastases.

GPA Interpretation

  • 3.5 - 4.0: Highly favorable prognosis
  • 2.5 - 3.0: Favorable prognosis
  • 1.5 - 2.0: Intermediate prognosis
  • 0.0 - 1.0: Poor prognosis
Guidelines & Evidence

Verified

Last Review: 2026

When to Use

When to Use

Patients with newly diagnosed brain metastases from Non-Small Cell Lung Cancer.
Used to counsel patients on prognosis and expected overall survival.
Crucial for determining whether to offer aggressive local CNS therapy (Stereotactic Radiosurgery [SRS] or resection) versus Whole Brain Radiation Therapy (WBRT) or best supportive care.

How it Works

Scoring Variables (0 to 4 Points Total)

Variable0 Points0.5 Points1.0 Point
Age> 69< 70N/A
Karnofsky Performance Status (KPS)< 7070 - 8090 - 100
Extracranial MetastasesPresentAbsentN/A
Number of Brain Mets> 41 - 4N/A
Gene Mutation (EGFR or ALK)Negative / UnknownN/APositive

Clinical Pearls

Survival Estimates & Radiotherapy Decisions

GPA 3.5 - 4.0: Median OS ~47 months. Highly favorable prognosis; aggressively manage with SRS to spare cognition, even for multiple lesions.
GPA 2.5 - 3.0: Median OS ~27 months. Standard candidate for SRS or resection.
GPA 1.5 - 2.0: Median OS ~15 months. Individualized approach based on systemic options.
GPA 0 - 1.0: Median OS ~7 months. Poor prognosis. Consider hospice or WBRT if highly symptomatic, though WBRT offers minimal survival benefit here.

The TKI Exception

For patients with EGFR or ALK mutations (who score highly), modern third-generation TKIs (like Osimertinib or Alectinib) have such profound CNS penetration that initial radiotherapy can sometimes be deferred entirely to avoid radiation necrosis.

The Evidence

Key Reference

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)

Sperduto PW et al. • JAMA Oncology. 2017;3(6):827-831

Last Comprehensive Review: 2026

Related Tools

TNM 9th Ed
PD-L1 TPS Interpretation
Oncology CalculatorsInternal Medicine CalculatorsEmergency Medicine Calculators
Have feedback about this calculator?Let us know.

Recent Journal Updates

Cancer MedicineJul 22, 2026
Pharmacoeconomic Analysis of Osimertinib Compared to Earlier‐Generation EGFR Inhibitors in EGFR‐Mutated NSCLC: A Systematic Review

Clinical Context

We think this might be relevant to the clinical guidance for NSCLC GPA for Brain Metastases.

PLOS MedicineJul 21, 2026
Brain aging patterns among nine neurological disorders: A case-control study

Clinical Context

We think this might be relevant to the clinical guidance for NSCLC GPA for Brain Metastases.

WHO NewsJul 15, 2026
New WHO guidelines: up to 45% of dementia risk could be prevented or delayed

Clinical Context

We think this might be relevant to the clinical guidance for NSCLC GPA for Brain Metastases.