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Department of Medicine and Surgery, University of Parma, Parma, Italy; Medical Oncology Unit, University Hospital of Parma, Parma, Italy
https://orcid.org/0000-0001-5196-8298Dipartimento di Oncologia, Azienda Ospedaliera Santa Maria of Terni, Terni, Italy
https://orcid.org/0000-0001-8520-7032Department of Life Sciences, Health and Health Professions, Link Campus University Rome, Italy
https://orcid.org/0000-0002-4359-5193Department of Health Sciences, University of Genoa, Genoa, Italy
https://orcid.org/0000-0001-6289-9144Medical Oncology Unit, Ospedale San Paolo, Savona, Italy
https://orcid.org/0000-0003-0546-6304Oncologia 3, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
https://orcid.org/0000-0002-6256-9249Oncologia 3, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
Oncologia 3, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
https://orcid.org/0000-0002-8483-0196Oncologia 1, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
https://orcid.org/0000-0001-8177-5374Oncologia 1, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
https://orcid.org/0000-0002-5075-2177SC Oncologia, Ospedale San Giacomo, Novi Ligure, Italy
https://orcid.org/0000-0001-5052-0870IRCCS National Cancer Institute Regina Elena Rome, Italy
https://orcid.org/0000-0002-7863-3540Department of Oncology, San Camillo Forlanini Hospital, Rome, Italy
SC Oncologia Medica, Azienda Ospedaliera Santa Maria della Misericordia, Perugia, Italy
https://orcid.org/0009-0003-3721-4520Dipartimento di Oncologia, Azienda Ospedaliera Santa Maria of Terni, Terni, Italy
https://orcid.org/0000-0001-9150-2134Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Santa Chiara Hospital, Pisa, Italy
Department of Medical Oncology, Medical Oncology, Santa Chiara Hospital, Trento, Italy
https://orcid.org/0000-0001-7968-2531Department of Oncology, AORN Cardarelli, Naples, Italy
https://orcid.org/0000-0001-5814-2296Dipartimento di Oncologia, Azienda Ospedaliera Santa Maria of Terni, Terni, Italy
https://orcid.org/0000-0002-0703-2959Department of Medicine and Surgery, University of Parma, Parma, Italy; Medical Oncology Unit, University Hospital of Parma, Parma, Italy
https://orcid.org/0000-0003-0876-0226Immunotherapy, Prognostic factors, Prognostic score, Renal Cell Carcinoma, Tyrosine kinase inhibitor
AbstractThe Meet-URO score provided a more accurate prognostication than the international metastatic RCC database consortium (IMDC) risk group classification for patients with metastatic renal cell carcinoma (mRCC) by incorporating the pretreatment neutrophil-to-lymphocyte ratio (NLR) and the presence of bone metastases in different settings of the disease. To additionally validate the Meet-URO score on overall survival (OS) in a cohort of mRCC patients treated with first-line pembrolizumab plus axitinib, a post hoc analysis of the observational prospective ProPAXI study was conducted. Progression-free survival (PFS) was also considered. Harrell’s C-index was used to compare the discriminative ability on OS and PFS. Overall, the ProPAXI study included 170 patients. Both the five- and the three-risk group Meet-URO score were evaluated to account for the small sample size. The five Meet-URO risk group score showed a mOS of 27.1 months (p = 0.064) and 10.3 (p = 0.014) months for group 4 and group 5, respectively, while it was not reached for the other groups (p < 0.01). Although a worsening of PFS was observed with increasing the risk group, these differences were not statistically significant (p =0.19). Similar results were observed fot the three-risk group Meet-URO score. Both five and the three Meet-URO risk groups showed a better C-index for OS (0.69 and 0.66, respectively) compared to IMDC (0.62) and for PFS (0.60 and 0.59, respectively) compared to IMDC (0.56). These findings suggest that the Meet-URO score may provide more accurate prognostic stratification than IMDC alone in mRCC patients treated with first-line pembrolizumab and axitinib.
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