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Lookup NU author(s): Dr Pasquale RescignoORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© 2022 The AuthorsBackground: The Meet-URO score allowed a more accurate prognostication than the International Metastatic RCC Database Consortium (IMDC) for patients with pre-treated metastatic renal cell carcinoma (mRCC) by adding the pre-treatment neutrophil-to-lymphocyte ratio and presence of bone metastases. Materials and methods: A post hoc analysis was carried out to validate the Meet-URO score on the overall survival (OS) of patients with IMDC intermediate-poor-risk mRCC treated with first-line nivolumab plus ipilimumab within the prospective Italian Expanded Access Programme (EAP). We additionally considered progression-free survival (PFS) and disease response rates. Harrell's c-index was calculated to compare the accuracy of survival prediction. Results: Overall the EAP included 306 patients, with a median follow-up of 12.2 months, median OS was not reached, 1-year OS was 66.8% and median PFS was 7.9 months. By univariable analysis, both the IMDC score and the two additional variables of the Meet-URO score were associated with either OS or PFS (P < 0.001 for all comparisons). The four Meet-URO risk groups (G) had 1-year OS of 92%, 72%, 50% and 21% for G2 (29.1% of patients), G3 (28.8%), G4 (33.0%) and G5 (9.1%), respectively. OS was significantly shorter in each consecutive G (P = 0.001 for G3, P < 0.001 for both G4 and G5 compared to G2). Similarly, Meet-URO Gs 2-5 showed decreasing median PFS and response rates. The Meet-URO score showed the highest c-index for both OS (0.73) and PFS (0.67). Limitations include the post hoc nature of this analysis and the lack of a comparative arm to assess predictive value. Conclusion: The Meet-URO score appeared to show better prognostic classification than the IMDC alone in patients with mRCC at IMDC intermediate-poor risk treated with first-line nivolumab and ipilimumab.
Author(s): Rebuzzi SE, Signori A, Buti S, Banna GL, Murianni V, Damassi A, Maruzzo M, Giannarelli D, Tortora G, Galli L, Rizzo M, De Giorgi U, Antonuzzo L, Bracarda S, Carteni G, Atzori F, Tamberi S, Procopio G, Fratino L, Lo Re G, Santoni M, Baldessari C, Astone A, Calabro F, Brunelli M, Porta C, Rescigno P, Basso U, Fornarini G
Publication type: Article
Publication status: Published
Journal: ESMO Open
Year: 2022
Volume: 7
Issue: 6
Print publication date: 01/12/2022
Online publication date: 06/12/2022
Acceptance date: 02/04/2022
Date deposited: 08/11/2024
ISSN (electronic): 2059-7029
Publisher: Elsevier B.V.
URL: https://doi.org/10.1016/j.esmoop.2022.100634
DOI: 10.1016/j.esmoop.2022.100634
PubMed id: 36493602
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