IUC24394-87 Meet-URO score update in metastatic renal cell carcinoma receiving first-line immune-combinations

Abstract

Background: Risk stratification is fundamental in guiding treatment decisions for mRCC patients. The Meet-URO score is a novel prognostic model (IMDC score + NLR + Bone metastases, PMID 36493602) developed in the immunotherapy era. This innovative score enhanced the prognostic discrimination compared with the IMDC score in patients receiving different therapeutic strategies in different settings. Methods: A previous external validation on a retrospective real-world cohort of 1174 mRCC patients receiving first-line immune-combinations from 27 centers showed the higher prognostic accuracy of the Meet-URO score compared with the IMDC score (Abstract n. IUC20761-50). Here, we report the updated OS assessment with an exploratory analysis for PFS and ORR. Results: A total of: 1,418 patients from 31 cancer centers were assessed: 54% of patients received IO-IO (Nivolumab + Ipilimumab), 46% IO-TKI, mainly Avelumab + Axitinib (24%); 52.5% of patients had NLR ≥ 3.2, and 32% had bone metastases. After an mFU of 16.5 months, the overall mOS was 34.7 months and resulted in more distinction within the Meet-URO score groups (Table 1), confirming its better prognostic accuracy compared with the IMDC score (c-index: 0.68 vs 0.64), especially for intermediate- and poor-risk patients, while for favorable patients, more FU is needed. Although the Meet-URO score was developed as an OS model, it showed better performance also in terms of PFS (c-index: 0.60 vs 0.58) and ORR (c-index: 0.57 vs 0.54). Conclusions: The Meet-URO score demonstrated robust and better performance compared with the IMDC score in a large-scale UK mRCC cohort receiving first-line immune-combinations, not only in terms of OS but also in terms of PFS and ORR. The adoption of the Meet-URO score in clinical practice and as a stratification factor of clinical trials could support more individualized patient management. Score Group distribution HR (95% CI) P value mOS(mo) 3y-OS Meet-URO 1 13% 1.00 (ref) 45.8 66% 2 27% 1.23 (0.88-1.72) .23 51.4 62% 3 22% 1.74 (1.24-2.44) .001 37.6 53% 4 30% 3.31 (2.42-4.51) <.001 19.7 32% 5 8% 4.82 (3.35-6.94) <.001 11.5 26% IMDC Favorable 19% 1.00 (ref) 45.8 61% Intermediate 53% 1.40 (1.09-1.79) .007 37.6 54% Poor 28% 3.23 (2.51-4.16) <.001 14.9 30%