BIOM-62. BASELINE NEUROLOGICAL FUNCTION ASSESSED BY NANO PREDICTS PROGRESSION-FREE SURVIVAL IN GLIOBLASTOMA

Abstract BACKGROUND The Neurologic Assessment in Neuro-Oncology (NANO) scale is a standardized clinician-friendly tool consisting of nine domains to assess neurological status in brain tumor patients. Combined with MRI, NANO offers a comprehensive clinician response outcome, particularly when clinical and radiologic responses diverge. Despite its growing use in clinical trials, NANO’s association with progression-free survival (PFS) and overall survival (OS) in glioblastoma (GBM) remains underexplored. METHODS The Molecular, Imaging, and Neurological Assessment Database for CNS tumors (MIND-CNS) is a prospective, multimodal database capturing molecular, imaging, and neurological information—including NANO scores and Karnofsky Performance Status (KPS) —at baseline and follow-up visits in glioma patients. We analyzed baseline NANO scores in relation to PFS in a real-world cohort of GBM patients. Survival distributions were compared using log-rank tests, and covariate effects were estimated via Cox proportional hazards models. RESULTS We evaluated 85 GBM patients (59% male, median age 63) with baseline NANO scores as part of their assessment at a tertiary Canadian center. Patients with any neurological deficit at baseline showed a trend towards shorter PFS (p < 0.06). Specifically, deficits in gait (p < 0.001), strength (p < 0.001), and facial function (p < 0.03) were associated with shorter PFS. Greater neurological deficit in multiple domains (higher cumulative baseline NANO score) also predicted shorter PFS (p < 0.04) and higher rates of progression at 3 months (p < 0.04), independent of age, sex, and MGMT promoter methylation status. KPS score was also independently associated with PFS at 3 months (p <0.04). CONCLUSION Baseline NANO scores predict PFS and early progression in GBM patients. While KPS also correlated with outcomes, NANO offered greater granularity by identifying specific deficits. A combined international cohort analysis of GBM patients (n = 181) is underway to further evaluate associations with overall survival.