ATLANTA – Prognostic scores offer some benefit in determining how patients with metastatic renal cell carcinoma will respond to immune checkpoint inhibitors, according to a recent study.
The research accepted by the 2021 American Society of Clinical Oncology (ASCO) annual meeting noted that the International Metastatic RCC Database Consortium (IMDC) and the Memorial Sloan-Kettering Cancer Center (MSKCC) risk models for mRCC were validated before the use of ICIs became widespread.1
Researchers from the Emory University School of Medicine and the Atlanta VAMC advised, meanwhile, that the modified Glasgow prognostic score (mGPS) incorporates albumin and C-reactive protein and reflects systemic inflammation.
They pointed out that “mGPS may be a useful prognostic biomarker of particular relevance in mRCC given the current, largely ICI-based treatment paradigm and hypothesis that systemic inflammation may contribute to ICI resistance.”
To determine that, the study team retrospectively assessed 156 mRCC patients treated with ICI — including anti-PD-1 and anti-PD-L1 agents– in any line of therapy at Winship Cancer Institute of Emory University from 2015-2018.
Participants, who had median follow-up of 24.2 months, had median age of 64 and were 69% male and 20% Black. Most, 78%, of the patients had clear cell histology, with 57.1% receiving anti-PD-1 monotherapy and all others receiving dual ICI or ICI combined with an antiangiogenic agent or experimental therapy in trial.
Overall survival (OS) and progression-free survival (PFS) were determined as primary outcomes. Researchers calculated mGPS by giving one point for CRP greater than 10 mg/L and/or albumin less than 3.5 g/dL with 0 points awarded for solitary low albumin.
Results indicated that higher baseline mGPS was significantly associated with worse overall- and progression-free survival. The median OS of patients with baseline mGPS of 0, 1 and 2 was 44.5 (CI 27.3, NA), 15.3 (CI 11, 24.2) and 10 (CI 4.6, 17.5) months, respectively (p<0.0001), while the median PFS of the three cohorts was 6.7 (CI 3.6, 13.1), 4.2 (CI 2.9, 6.2) and 2.6 (CI 2, 5.6) months, respectively (p=0.0216).
“A higher mGPS at the start of therapy was negatively prognostic in patients with mRCC receiving ICI,” researchers concluded. “These results should be validated in a larger, prospective study.”
- Brown JT, Liu Y, Martini DJ, Shabto JM. (June 4-8, 2021). Baseline modified Glasgow prognostic score (mGPS) in patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitors (ICI). ASCO 2021 annual meeting. Virtual. https://meetinglibrary.asco.org/record/197843/abstract