Exploration of IMDC model in patients with metastatic renal cell carcinoma using targeted agents: a meta-analysis

Abstract

Purpose: To explore the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model application for predicting outcome of patients with metastatic renal cell carcinoma using targeted agents. Materials and Methods: We performed a literature review of 989 articles. The selecting process used preferred reporting items for systematic reviews and meta-analyses (PRISMA). All included studies were assessed by Newcastle-Ottawa scale. Results of individual studies were pooled using Stata 14.0 software. Results: A total of 17 articles were included. Most articles provided univariate and multivariate analysis of IMDC model prognosis. Combined HRs were 1.58 (95% CI 1.34-1.82) and 3.74 (95% CI 2.67-4.81) for univariate PFS of intermediate to favorable and poor to favorable respectively. In the category of multivariate PFS, combined HRs were 1.27 (95% CI 0.99-1.56) and 2.29 (95% CI 1.65-2.93) with intermediate to favorable and poor to favorable respectively. Regarding univariate OS, combined HRs were 1.93 (95% CI 1.62-2.24) and 6.25 (95% CI 4.18-8.31) with intermediate to favorable and poor to favorable respectively. With multivariate OS, combined HRs were 1.32 (95%CI 1.04-1.59) and 2.35 (95%CI 1.69-3.01) with intermediate to favorable and poor to favorable respectively. Conclusion: In summary, analysis of currently available clinical evidence indicated that IMDC model could be applied to classify patients with metastatic renal cell carcinoma using targeted agents. However, different types of targeted agents and various areas could affect the accuracy of the model. There was also a difference in predicting patients' PFS and OS.

Prognostic significance of 18F-FDG PET/CT indices in metastatic renal cell cancer and evaluation of revised IMDC risk model by including 18F-FDG PET-CT parameters

“…Heng et al retrospectively analyzed a large cohort of 645 patients with mRCC treated with first-line therapy and demonstrated that more than half of the patients (52%) were in the intermediate-risk group (7). In the meta-analysis evaluating the IMDC model, the intermediate-risk group comprised >50% of patients in 14 of 17 studies (11). Therefore, identifying a subgroup with a relatively poor prognosis in such a wide intermediate-risk group appears to be critical in the management of patients with mRCC.…”

“…In the prognostic model, six parameters (hemoglobin, corrected serum calcium, neutrophil count, platelet count, performance status [PS], time from diagnosis to start of treatment) were identified to stratify patients into favorable, intermediate-risk, and poor-risk groups. The remarkable point in the IMDC score is that the majority of patients are in the intermediate-risk group in both the primary study and the subsequent meta-analysis (7,11). Tumor burden could differ tremendously in the intermediate-risk group patients.…”

Influence of treatment access on survival of metastatic renal cell carcinoma in brazilian cancer center

“…The IMDC risk model has been extensively validated and is used to estimate survival with targeted therapies (19). One hypothesis for the higher incidence of poor IMDC risk in the PHS patients may be delays in diagnosis and reduced access to specialized cancer centers, resulting in more advanced disease stages at the beginning of treatment.…”