Abstract Code: IUC24358-87
Prognostic assessment of the Meet-URO score compared with the IMDC score in Metastatic Renal Cell Carcinoma (mRCC) receiving 1st line systemic therapies (Meet-URO 33 study)
S.E. Rebuzzi 1, C. Messina 2, L. Bonomi 3, S. Scagliarini 4, S. Chiellino 5, B.A. Maiorano 6, F.M. Deppieri 7, A. Cavo 8, V. Conteduca 9, D. Bimbatti 10
(1) Medical Oncology Unit 2, Ospedale Molinette Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino – Italy, (2) Oncology Unit, ARNAS Civico, Palermo – Italy, (3) Unit of Oncology, ASST Papa Giovanni XXIII Hospital, Bergamo – Italy, (4) UOC di Oncologia, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli – Italy, (5) Medical Oncology , I.R.C.C.S. San Matteo University Hospital Foundation , Pavia – Italy, (6) IRCCS Ospedale San Raffaele, Milano – Italy, (7) Ospedale dell’Angelo, AULSS 3 Serenissima, Mestre – Italy, (8) Oncology Unit, Villa Scassi Hospital, Genova – Italy, (9) Unit of Medical Oncology and Biomolecular Therapy, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti, Foggia – Italy, (10) Oncology Unit 1, Istituto Oncologico Veneto, IOV – IRCCS, Padova – Italy
Sara Elena Rebuzzi, Carlo Messina, Lucia Bonomi, Sarah Scagliarini, Silvia Chiellino, Brigida Anna Maiorano, Filippo Maria Deppieri, Alessia Cavo, Vincenza Conteduca, Silvia Zai, Paolo Andrea Zucali, Martino Rabino, Francesca Vignani, Francesca La Russa, Claudia Mucciarini, Claudia Caserta, Federico Paolieri, Davide Bimbatti
Background: The prognostic stratification is the cornerstone of treatment decision-making for mRCC. The novel Meet-URO score (IMDC score + NLR + Bone metastases) was developed in the immunotherapy era and has shown better prognostic performance compared with the IMDC score in different settings. Its application in the 1st line IO-TKI setting was awaited.
Methods: The Meet-URO 33 is a multicentric prospective observational study enrolling mRCC patients receiving 1st-line systemic therapy. A retrospective cohort of patients treated from 01.01.2021 was included. The Meet-URO score was assessed compared with the IMDC score in predicting OS. An exploratory analysis on PFS was also conducted.
Results: 1557 patients were enrolled, 1400 (90%) were assessable. Median age was 66 years, 75% were males, 84% had clear cells, and 64% underwent nephrectomy; 20% received IO-IO, 66% IO-TKI (32% Pembrolizumab+Axitinib) and 14% TKI; 45% had NLR≥3.2 and 29% bone metastases.
After a mFU of 14.1 months, mOS was 40.5 months and mPFS was 16.8 months. The Meet-URO score confirmed a better prognostic stratification compared with the IMDC score (c-index 0.714 vs 0.688) (Table 1). Although the Meet-URO score was developed as an OS model, it showed a similar PFS performance (c-index 0.62 vs 0.61).
| Score | Group distribution | HR (95%CI) | p value | mOS (months) | 3y-OS |
| Meet-URO | |||||
| 1 | 16% | Ref | NR | 85% | |
| 2 | 30% | 2.19 (1.34-3.56) | 0.002 | NR | 64% |
| 3 | 22% | 3.62 (2.22-5.90) | <0.001 | 37.8 | 52% |
| 4 | 24% | 6.76 (4.25-10.75) | <0.001 | 22.4 | 35% |
| 5 | 8% | 12.59 (7.54-21.04) | <0.001 | 10.9 | 18% |
| IMDC | |||||
| Favorable | 21% | Ref | NR | 82% | |
| Intermediate | 57% | 2.97 (1.99-4.42) | <0.001 | 43.7 | 56% |
| Poor | 22% | 8.45 (5.61-12.70) | <0.001 | 13.7 | 26% |
Conclusions: The Meet-URO score confirmed its better prognostic accuracy compared with the IMDC score, also in a large-scale prospective cohort receiving 1st line therapy. The adoption of the Meet-URO score should be implemented in clinical practice and as a stratification factor of clinical trials for more individualized patient management.