OBJECTIVE: To provide a review of the current status of predictive nomograms and 
brain metastasis velocity (BMV) in the prognostication of brain metastasis 
outcomes.
BACKGROUND: Statistical analyses have been used for many years in an attempt to 
predict clinical outcomes of brain metastasis patients. Such models have 
attempted to predict such endpoints as survival and which patients would most 
benefit from stereotactic radiosurgery (SRS) or whole brain radiotherapy (WBRT).
METHODS: This narrative review includes documents the history of statistical 
models and nomograms through the stage migration of the brain metastasis 
population from a population with large symptomatic brain metastases to the 
modern population with small asymptomatic metastases found on surveillance 
imaging. It also tells the history of the derivation and validation of BMV, a 
recently identified biomarker for survival and neurologic death in the brain 
metastasis population treated with SRS.
CONCLUSIONS: Statistical models predicting brain metastasis behavior continue to 
evolve with the changing landscape of systemic therapy and the more aggressive 
use of SRS. Previous models with ultimately need to integrate biologic data and 
will continue to be updated.