Prognostic scores for predicting overall survival in patients with metastatic renal and urothelial cancer undergoing immunotherapy - which one to use? - Summary - MDSpire
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Prognostic scores for predicting overall survival in patients with metastatic renal and urothelial cancer undergoing immunotherapy - which one to use?
To evaluate the reliability of various prognostic scoring systems in predicting overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) and urothelial carcinoma (mUC) undergoing immunotherapy (IO), emphasizing the clinical relevance of these findings.
Key Findings:
High NLR and SII were associated with worse progression-free survival (PFS) and OS, indicating a need for careful patient monitoring.
Low SII correlated with longer OS and better PFS in mRCC patients, suggesting its potential as a positive prognostic indicator.
Lower NER was linked to improved OS, PFS, and overall response rate (ORR) in mRCC, highlighting its importance in treatment planning.
mGPS integration may provide additional prognostic information beyond radiologic staging, which could enhance clinical decision-making.
Interpretation:
No universally accepted risk score exists for metastatic urological cancers in the context of IO, but NLR, SII, NER, and mGPS are the most studied and show potential in predicting treatment response, which could significantly influence patient management.
Limitations:
Retrospective design may introduce bias; future studies should consider prospective designs.
Small sample size limits generalizability; larger cohorts are needed for validation.
Lack of external validation for the scoring systems; future research should focus on multi-center studies to confirm findings.
Conclusion:
The study highlights the urgent need for reliable, evidence-based prognostic scoring systems to optimize treatment and avoid overtreatment in patients with mRCC and mUC undergoing immunotherapy.
by Margarete Teresa Walach, Ralph Burger, Felix Brumm, Katja Nitschke, Frederik Wessels, Philipp Nuhn, Thomas Stephan Worst, Jost von Hardenberg, Britta Grüne, Jonas Jarczyk
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