Abstract Code: IUC24394-87

Meet-URO score update in Metastatic Renal Cell Carcinoma receiving 1st line Immune-Combinations

Pasquale Rescigno¹, Aruni Ghose², Nicholas Brown³, Lijo James⁴, Sophia Haywood⁵, Ricky Frazer⁶, Anupama Vijay⁷, Mark Stares⁸, Michael Cheung⁹, Ishika Mahajan¹⁰, Niall Moon¹¹, Ritika Abrol¹², Ondrej Fiala¹³, Vishwani Chauhan², Yamin Shwe Yee Soe¹⁴, Anum Zargham¹⁵, Sara Elena Rebuzzi¹⁶

1. Centre for Cancer, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK; 2. Barts Cancer Centre, Barts Health NHS Trust, London, UK; 3. Cancer Centre at Guy’s, Guy’s and St Thomas’ NHS Foundation Trust, London, UK; 4. Beatson West of Scotland Cancer Centre, NHS Greater Glasgow and Clyde, Glasgow, UK; 5. Department of Medical Oncology, The Royal Marsden NHS Foundation Trust, London, UK; 6. Velindre Cancer Centre, Velindre University NHS Trust, Cardiff, UK; 7. Leicester Cancer Research Centre, University Hospitals of Leicester NHS Trust, Leicester, UK; 8. Edinburgh Cancer Centre, NHS Lothian, Edinburgh, UK; 9. Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, UK; 10. Lincoln Oncology Centre, United Lincolnshire Hospitals NHS Trust, Lincoln, UK; 11. Sunrise Oncology Centre, Royal Cornwall Hospitals NHS Trust, Cornwall, UK; 12. Deanesly Centre for Cancer Services, The Royal Wolverhampton NHS Trust, Wolverhampton, UK; 13. Department of Oncology and Radiotherapeutics, Faculty of Medicine, University Hospital in Pilsen, Charles University Prague, Czech Republic; 14. Royal Surrey Cancer Centre, Royal Surrey NHS Foundation Trust, Guildford, UK; 15. Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; 16. Medical Oncology Unit 2, Molinette Hospital – AOU Città della Salute e della Scienza, Turin, Italy.

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 1^st line immune-combinations from 27 centres 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: 1418 patients from 31 cancer centres 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 (mo), the overall mOS was 34.7 mo 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 1^st 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.