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Application of the Meet-URO score to metastatic renal cell carcinoma patients treated with second- and third-line cabozantinib
BACKGROUND: The addition of neutrophil-to-lymphocyte ratio (NLR) and bone metastases to the International Metastatic RCC Database Consortium (IMDC) score (by the Meet-URO score) has been shown to better stratify pretreated metastatic renal cell carcinoma (mRCC) patients receiving nivolumab. This stu...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8883304/ https://www.ncbi.nlm.nih.gov/pubmed/35237353 http://dx.doi.org/10.1177/17588359221079580 |
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author | Rebuzzi, Sara Elena Cerbone, Luigi Signori, Alessio Santoni, Matteo Murianni, Veronica De Giorgi, Ugo Procopio, Giuseppe Porta, Camillo Milella, Michele Basso, Umberto Massari, Francesco Maruzzo, Marco Iacovelli, Roberto Battelli, Nicola Carmisciano, Luca Banna, Giuseppe Luigi Buti, Sebastiano Fornarini, Giuseppe |
author_facet | Rebuzzi, Sara Elena Cerbone, Luigi Signori, Alessio Santoni, Matteo Murianni, Veronica De Giorgi, Ugo Procopio, Giuseppe Porta, Camillo Milella, Michele Basso, Umberto Massari, Francesco Maruzzo, Marco Iacovelli, Roberto Battelli, Nicola Carmisciano, Luca Banna, Giuseppe Luigi Buti, Sebastiano Fornarini, Giuseppe |
author_sort | Rebuzzi, Sara Elena |
collection | PubMed |
description | BACKGROUND: The addition of neutrophil-to-lymphocyte ratio (NLR) and bone metastases to the International Metastatic RCC Database Consortium (IMDC) score (by the Meet-URO score) has been shown to better stratify pretreated metastatic renal cell carcinoma (mRCC) patients receiving nivolumab. This study aimed to validate the Meet-URO score in patients receiving cabozantinib to assess its predictivity and prognostic role. METHODS: A multicenter retrospective analysis evaluated mRCC patients receiving ⩾second-line cabozantinib. NLR, IMDC score and bone metastases were assessed before the start of cabozantinib. The primary endpoint was overall survival (OS). Harrell’s c-index was calculated to compare the accuracy of the prediction of the two scores. RESULTS: Overall, 174 mRCC patients received cabozantinib as second and third line (51.7% and 48.3%, respectively) with a median follow-up of 6.8 months. A shorter median overall survival (mOS) was observed for the IMDC poor-risk group, NLR ⩾3.2 and the presence of bone metastases, while the IMDC intermediate-risk group had a similar mOS to the favourable-risk one. Applying the Meet-URO score, three risk groups were identified: group 1 (55.2% of patients) with a score of 0–3, group 2 (38.5%) with a score of 4–8 and group 3 (6.3%) with a score of 9. Compared to group 1 (mOS: 39.4 months), a statistically significant worse mOS was observed in group 2 (11.2 months) and group 3 (3.2 months) patients, respectively. The Meet-URO c-index score was 0.640, showing a higher discriminative ability than the IMDC score (c-index: 0.568). CONCLUSION: This analysis showed that the Meet-URO score provides a more accurate prognostic stratification than the IMDC score in mRCC patients treated with ⩾second-line cabozantinib besides nivolumab. Moreover, it is an easy-to-use tool with no additional costs for clinical practice (web-calculator is available at: https://proviso.shinyapps.io/Meet-URO15_score/). Future investigations will include the application of the Meet-URO score to the first-line immunotherapy-based combination therapies. |
format | Online Article Text |
id | pubmed-8883304 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-88833042022-03-01 Application of the Meet-URO score to metastatic renal cell carcinoma patients treated with second- and third-line cabozantinib Rebuzzi, Sara Elena Cerbone, Luigi Signori, Alessio Santoni, Matteo Murianni, Veronica De Giorgi, Ugo Procopio, Giuseppe Porta, Camillo Milella, Michele Basso, Umberto Massari, Francesco Maruzzo, Marco Iacovelli, Roberto Battelli, Nicola Carmisciano, Luca Banna, Giuseppe Luigi Buti, Sebastiano Fornarini, Giuseppe Ther Adv Med Oncol Original Research BACKGROUND: The addition of neutrophil-to-lymphocyte ratio (NLR) and bone metastases to the International Metastatic RCC Database Consortium (IMDC) score (by the Meet-URO score) has been shown to better stratify pretreated metastatic renal cell carcinoma (mRCC) patients receiving nivolumab. This study aimed to validate the Meet-URO score in patients receiving cabozantinib to assess its predictivity and prognostic role. METHODS: A multicenter retrospective analysis evaluated mRCC patients receiving ⩾second-line cabozantinib. NLR, IMDC score and bone metastases were assessed before the start of cabozantinib. The primary endpoint was overall survival (OS). Harrell’s c-index was calculated to compare the accuracy of the prediction of the two scores. RESULTS: Overall, 174 mRCC patients received cabozantinib as second and third line (51.7% and 48.3%, respectively) with a median follow-up of 6.8 months. A shorter median overall survival (mOS) was observed for the IMDC poor-risk group, NLR ⩾3.2 and the presence of bone metastases, while the IMDC intermediate-risk group had a similar mOS to the favourable-risk one. Applying the Meet-URO score, three risk groups were identified: group 1 (55.2% of patients) with a score of 0–3, group 2 (38.5%) with a score of 4–8 and group 3 (6.3%) with a score of 9. Compared to group 1 (mOS: 39.4 months), a statistically significant worse mOS was observed in group 2 (11.2 months) and group 3 (3.2 months) patients, respectively. The Meet-URO c-index score was 0.640, showing a higher discriminative ability than the IMDC score (c-index: 0.568). CONCLUSION: This analysis showed that the Meet-URO score provides a more accurate prognostic stratification than the IMDC score in mRCC patients treated with ⩾second-line cabozantinib besides nivolumab. Moreover, it is an easy-to-use tool with no additional costs for clinical practice (web-calculator is available at: https://proviso.shinyapps.io/Meet-URO15_score/). Future investigations will include the application of the Meet-URO score to the first-line immunotherapy-based combination therapies. SAGE Publications 2022-02-26 /pmc/articles/PMC8883304/ /pubmed/35237353 http://dx.doi.org/10.1177/17588359221079580 Text en © The Author(s), 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Rebuzzi, Sara Elena Cerbone, Luigi Signori, Alessio Santoni, Matteo Murianni, Veronica De Giorgi, Ugo Procopio, Giuseppe Porta, Camillo Milella, Michele Basso, Umberto Massari, Francesco Maruzzo, Marco Iacovelli, Roberto Battelli, Nicola Carmisciano, Luca Banna, Giuseppe Luigi Buti, Sebastiano Fornarini, Giuseppe Application of the Meet-URO score to metastatic renal cell carcinoma patients treated with second- and third-line cabozantinib |
title | Application of the Meet-URO score to metastatic renal cell carcinoma patients treated with second- and third-line cabozantinib |
title_full | Application of the Meet-URO score to metastatic renal cell carcinoma patients treated with second- and third-line cabozantinib |
title_fullStr | Application of the Meet-URO score to metastatic renal cell carcinoma patients treated with second- and third-line cabozantinib |
title_full_unstemmed | Application of the Meet-URO score to metastatic renal cell carcinoma patients treated with second- and third-line cabozantinib |
title_short | Application of the Meet-URO score to metastatic renal cell carcinoma patients treated with second- and third-line cabozantinib |
title_sort | application of the meet-uro score to metastatic renal cell carcinoma patients treated with second- and third-line cabozantinib |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8883304/ https://www.ncbi.nlm.nih.gov/pubmed/35237353 http://dx.doi.org/10.1177/17588359221079580 |
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