Modified Glasgow Prognostic Score as a Predictor of Prognosis in Metastatic Renal Cell Carcinoma Treated With Nivolumab

Fujiwara, Ryo; Takemura, Kosuke; Fujiwara, Motohiro; Yuasa, Takeshi; Yasuoka, Shotaro; Komai, Yoshinobu; Numao, Noboru; Yamamoto, Shinya; Yonese, Junji

doi:10.1016/j.clgc.2020.10.007

Cited by 10 publications

(9 citation statements)

References 20 publications

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“… 30 The elevated levels of CRP to more than 10mg/mL, combined with the levels of ALB decreased to less than 32 g/L indicated the highest HRs on survival. 31 Therefore, similar with other studies, 32 , 33 two key inflammation components, CRP and ALB contributed to the significantly higher predictive power of mGPS, compared with other inflammation-based indexes. These results provided insight into the relationship between inflammation and survival, serving the purpose of detailing prognostic information of mGPS.…”

Section: Discussionsupporting

confidence: 84%

An Inflammation-Index Signature Predicts Prognosis of Patients with Intrahepatic Cholangiocarcinoma After Curative Resection

Zhao

Chen

et al. 2021

JIR

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Background:The prognosis of patients with intrahepatic cholangiocarcinoma (ICC) after resection is at great variance. We aimed to establish a novel prognostic nomogram in facilitating the risk stratification for these patients. Methods: A total of 82 high-dimensional radiological and pathological data were analyzed by LASSO-penalized Cox regression analyses and the panels with the best predictive performance were selected. Specific nomograms were established based on the selected panels and were validated in both primary (n=292) and validation cohorts (n=107). The area under the receiver operating characteristic curve (AUC) and the concordance index (C-index) were used to compare the predictive ability of nomograms and other staging systems. Results: The modified Glasgow Prognostic Score (mGPS) was identified as the prognostic factor for both overall survival (OS) and progression-free survival (PFS). The nomograms built on the prognostic factors showed powerful efficacy in survival prediction, with C-indexes of 0.800 (95% CI 0.767-0.833) and 0.752 (95% CI 0.718-0.786) for OS and PFS in the primary cohort, 0.659 (95% CI 0.586-0.732) and 0.638 (95% CI 0.571-0.705) for OS and PFS in the validation cohort, respectively. Compared with tumor-node-metastasis stage, Barcelona Clinic Liver Cancer staging score, Cancer of the Liver Italian Program score, and Okuda staging system, the nomograms had significantly higher values of AUC and C-indexes in survival prediction in the primary and validation cohorts. Conclusion: Compared with currently used staging systems, the nomograms showed significantly higher efficacy in predicting survival of ICC patients after resection. The nomograms provide new versions of personalized management for these patients.

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Section: Discussionsupporting

confidence: 84%

An Inflammation-Index Signature Predicts Prognosis of Patients with Intrahepatic Cholangiocarcinoma After Curative Resection

Zhao

Chen

et al. 2021

JIR

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“…The mGPS is a scoring system that works using serum albumin and CRP values to verify systemic inflammation and nutritional status. [21] Researchers posit that the mGPS has prediction value in pancreatic, esophagus, and lung cancers, and its prognostic ability in cancer was indicated by various studies. [22] Tsujino et al reported that a preoperative measurement using the mGPS predicts survival in nonmetastatic renal cell carcinoma prior to nephrectomy.…”

Section: Discussionmentioning

confidence: 99%

Inflamasyon ilişkili indeksler, palyatif bakım hastalarında kötü prognozu tanımlayabilir mi?

Ünlü

Çeltek

2022

Journal of Contemporary Medicine

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Aim: Palliative medicine provides holistic care to increase the quality of life of patients. Predicting prognosis is critical for a personalized treatment plan. Therefore, we aimed to investigate the survival prediction properties of routine biochemistry tests, complete blood count (CBC) and neutrophil/lymphocyte ratios, in addition to biomarker-based indices (the mGPS, PI, and PNI). Materials and methods: The laboratory parameter values, prognostic factor scores, diagnoses and survival time of 139 palliative care patients in the last 5 weeks of their life were evaluated retrospectively. Results: Ninety-one (65.5%) patients were male and the average age was 65.9 years (28–91 years). Results of all three prognostic indices (the mGPS, PI, and PNI) investigated in this study were found to have a statistically significant relationship with the survival time of our patients. In addition, NLR, neutrophil percent, hemoglobin, serum albumin and CRP values were seen to have a statistically significant relationship with the scores of all three prognostic indices. Moreover, hand it is detected that WBC, NLR, albumin, and CRP values were associated with overall survival. Conclusion: The results of our study, which showed that these indices have prognostic markers in palliative care patients, will guide the management of the clinical process. We would like to emphasize the importance of palliative care clinicians in developing personalized treatment plans for patients using prognostic tools for survival prediction.

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“…Fujiwara et al found the mGPS to be prognostic in 45 patients with mRCC treated with nivolumab in the second line. 21 We have expanded on their work to include a larger cohort treated with ICI as a single agent but also in combination with another ICI, antiangiogenic therapy or a novel experimental treatment. In addition, 38% of our cohort received ICI in the first line setting.…”

Section: Discussionmentioning

confidence: 99%

“…17 The mGPS has been validated in nonmetastatic clear cell RCC treated with nephrectomy [18][19][20] and more recently in a small cohort of patients with metastatic disease treated with nivolumab monotherapy in the second-line setting after targeted therapy. 21 We sought to investigate its prognostic significance more broadly in patients with mRCC treated with immunotherapy in any line of therapy.…”

Section: Introductionmentioning

confidence: 99%

Modified Glasgow Prognostic Score associated with survival in metastatic renal cell carcinoma treated with immune checkpoint inhibitors

Brown

Liu

Shabto

et al. 2021

J Immunother Cancer

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BackgroundThe modified Glasgow Prognostic Score (mGPS) is a composite biomarker that uses albumin and C reactive protein (CRP). There are multiple immune checkpoint inhibitor (ICI)-based combinations approved for metastatic renal cell carcinoma (mRCC). We investigated the ability of mGPS to predict outcomes in patients with mRCC receiving ICI.MethodsWe retrospectively reviewed patients with mRCC treated with ICI as monotherapy or in combination at Winship Cancer Institute between 2015 and 2020. Overall survival (OS) and progression-free survival (PFS) were measured from the start date of ICI until death or clinical/radiographical progression, respectively. The baseline mGPS was defined as a summary score based on pre-ICI values with one point given for CRP>10 mg/L and/or albumin<3.5 g/dL, resulting in possible scores of 0, 1 and 2. If only albumin was low with a normal CRP, no points were awarded. Univariate analysis (UVA) and multivariate analysis (MVA) were carried out using Cox proportional hazard model. Outcomes were also assessed by Kaplan-Meier analysis.Results156 patients were included with a median follow-up 24.2 months. The median age was 64 years and 78% had clear cell histology. Baseline mGPS was 0 in 36%, 1 in 40% and 2 in 24% of patients. In UVA, a baseline mGPS of 2 was associated with shorter OS (HR 4.29, 95% CI 2.24 to 8.24, p<0.001) and PFS (HR 1.90, 95% CI 1.20 to 3.01, p=0.006) relative to a score of 0; this disparity in outcome based on baseline mGPS persisted in MVA. The respective median OS of patients with baseline mGPS of 0, 1 and 2 was 44.5 (95% CI 27.3 to not evaluable), 15.3 (95% CI 11.0 to 24.2) and 10 (95% CI 4.6 to 17.5) months (p<0.0001). The median PFS of these three cohorts was 6.7 (95% CI 3.6 to 13.1), 4.2 (95% CI 2.9 to 6.2) and 2.6 (95% CI 2.0 to 5.6), respectively (p=0.0216). The discrimination power of baseline mGPS to predict survival outcomes was comparable to the IMDC risk score based on Uno’s c-statistic (OS: 0.6312 vs 0.6102, PFS: 0.5752 vs 0.5533).ConclusionThe mGPS is prognostic in this cohort of patients with mRCC treated with ICI as monotherapy or in combination. These results warrant external and prospective validation.

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Modified Glasgow Prognostic Score as a Predictor of Prognosis in Metastatic Renal Cell Carcinoma Treated With Nivolumab

Cited by 10 publications

References 20 publications

An Inflammation-Index Signature Predicts Prognosis of Patients with Intrahepatic Cholangiocarcinoma After Curative Resection

An Inflammation-Index Signature Predicts Prognosis of Patients with Intrahepatic Cholangiocarcinoma After Curative Resection

Inflamasyon ilişkili indeksler, palyatif bakım hastalarında kötü prognozu tanımlayabilir mi?

Modified Glasgow Prognostic Score associated with survival in metastatic renal cell carcinoma treated with immune checkpoint inhibitors

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