The addition of neutrophil to lymphocyte ratio (NLR) and bone metastases to the IMDC classification provided by the Meet-URO score, resulted in higher prognostic accuracy in metastatic renal cell carcinoma (mRCC) patients receiving ≥2nd line nivolumab or cabozantinib in 2 retrospective analyses and 1st line nivolumab-ipilimumab in an expanded access programme.
Prognostic estimates for older mRCC patients might be key for clinical decision-making.
The outcome of real-world older (≥70 years) mRCC patients treated with any line cabozantinib within the multicenter observational prospective ZEBRA (Meet-URO 9) study was analyzed according to the baseline Meet-URO score. The primary endpoint was overall survival (OS). The discriminative ability by Harrell's c-index and calibration were assessed to compare the Meet-URO and IMDC scores.
A total of 104 mRCC patients received cabozantinib as 1st (38%), 2nd (20%), or ≥3rd (41%) line. With a median follow-up of 11.2 months, the median OS (mOS) was of 18.4 months. According to the IMDC score, favorable (15%), intermediate (65%) and poor-risk (19%) patients had a mOS not reached, of 15.6 and 5.7 months respectively (p = .011). According to the Meet-URO score groups, mOS was not reached in both group 1 (10%) and group 2 (25%), while in group 3 (33%), group 4 (25%) and group 5 (8%) mOS was of 13.6, 12.5, and 3.7 months, respectively (p < .001). The discriminative ability of the Meet-URO score was maintained by merging groups 1 to 2 vs. 3 to 4 vs. 5 (p < .001). The Meet-URO score (with either the original 5-group stratification or the modified 3-group one) showed higher accuracy than the IMDC score (c-index of 0.686 and 0.676 vs. 0.622).
This analysis confirmed the prognostic accuracy of the Meet-URO score in older mRCC patients treated with cabozantinib and its role as a convenient tool for informing the patient and clinical decisions.
Clinical genitourinary cancer. 2023 Oct 06 [Epub ahead of print]
Alessandra Damassi, Malvina Cremante, Alessio Signori, Sara Elena Rebuzzi, Giuseppe Fornarini, Giulia Claire Giudice, Marco Maruzzo, Giuseppe Procopio, Mariella Sorarù, Marilena Di Napoli, Lucia Fratino, Daniele Santini, Francesco Grillone, Melissa Ballestrin, Michele Dionese, Cecilia Nasso, Fabio Catalano, Veronica Murianni, Pasquale Rescigno, Shobana Anpalakhan, Giuseppe Luigi Banna, Umberto Basso, Sebastiano Buti
Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy., Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genova, Genova, Italy., Medical Oncology Unit, Ospedale San Paolo, Savona, Italy; Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, Genova, Italy. Electronic address: ., Department of Medicine and Surgery, University of Parma, Parma, Italy., Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy., SS Oncologia Medica Genitourinaria, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan., U.O. Oncologia, Ospedale di Camposampiero, Camposampiero, Italy., Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy., Department of Medical Oncology, Centro di Riferimento, Oncologico di Aviano CRO-IRCCS, Aviano, Italy., UOC Oncologia Medica, "Sapienza University", Polo Pontino, Rome, Italy., Azienda Ospedaliero-Universitario "Mater Domini", Policlinico of Catanzaro, Catanzaro, Italy., Medical Oncology Unit, Ospedale Santa Corona, Pietra Ligure, Italy., Translational and Clinical Research Institute, Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK; Candiolo Cancer Institute, FPO-IRCCS, Turin, Italy., Department of Oncology, Portsmouth Hospitals University NHS Trust, Portsmouth, PO6 3LY, UK., Department of Oncology, Portsmouth Hospitals University NHS Trust, Portsmouth, PO6 3LY, UK; Faculty of Science and Health, School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, PO1 2UP, UK., Department of Medicine and Surgery, University of Parma, Parma, Italy; Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/37932204