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In the Phase III IMmotion151 Trial of Metastatic Renal Cell Carcinoma the Easy-to-Implement Modified Glasgow Prognostic Score Predicts Outcome More Accurately than the IMDC Score

The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) score is relevant for the first-line treatment decision in patients with metastatic renal cell carcinoma (mRCC).1 The IMDC score was introduced many years before the era of immune checkpoint inhibitors (ICIs) entered the first-line treatment of mRCC. It is based on a total of six clinical and laboratory parameters, and patients are classified into good (0 points), intermediate (1-2 points), or poor prognosis (≥3 points). There are several limitations to the IMDC score. First, assessment of Karnofsky performance status is subjective, biased, and subject to high interobserver variability.2 Second, because adjuvant ICI is now approved for patients who are at high risk for recurrence after nephrectomy, the IMDC risk factor ‘time from diagnosis to initiation of systemic therapy (≤12 months)’ needs to be reviewed in this new treatment setting. Third, the original score was based on a retrospective and heterogeneous dataset of N = 645 patients who received different therapies (sunitinib, sorafenib, or bevacizumab plus interferon) that play a minor role in current first-line therapy for patients with mRCC.1

Written by: J. Saal,1,2,3 T. Bald,2,3 M. Hölzel,2,3 M. Ritter,3,4 P. Brossart,1,3 J. Ellinger,3,4 N. Klümper2,3,4


  1. Medical Clinic III for Oncology, Hematology, Immune-Oncology and Rheumatology, University Medical Center Bonn (UKB), Bonn;
  2. Institute of Experimental Oncology, University Medical Center Bonn (UKB), Bonn;
  3. Center for Integrated Oncology Aachen/Bonn/Cologne/Düsseldorf (CIO-ABCD), Bonn;
  4. Department of Urology and Pediatric Urology, University Medical Center Bonn (UKB), Bonn, Germany

References:

  1. Heng D.Y.C., Xie W., Regan M.M. et al. Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. J Clin Oncol. 2009; 27: 5794-5799
  2. Kelly C.M., Shahrokni A. Moving beyond Karnofsky and ECOG performance status assessments with new technologies. J Oncol. 2016; 2016: 1-13

Source: Saal J., Bald T., Hölzel M. et al. "In the Phase III IMmotion151 Trial of Metastatic Renal Cell Carcinoma the Easy-to-Implement Modified Glasgow Prognostic Score Predicts Outcome More Accurately than the IMDC Score." Annals of Oncology. 2022. https://doi.org/10.1016/j.annonc.2022.06.003