Assessment of Multiple Prognostic Scores in Patients With Metastatic Renal Cell Carcinoma Receiving First-Line,...

Combination immunotherapy is widely used as first-line treatment for metastatic renal cell carcinoma (mRCC), but pretreatment prognostic stratification remains insufficiently established.

To evaluate the performance of various prognostic scores in the first-line treatment of metastatic renal cell carcinoma (mRCC) with combination immunotherapy.

We retrospectively analyzed 145 patients who started first-line combination immunotherapy at six institutions from December 2015 to February 2025. We calculated IMDC, LIPI, RMH, PMHI, GRIm, C-PLAN, mGPS, and Meet-URO scores and performed survival (PFS, OS) and ROC analyses (PD, ORR). Survival analyses also evaluated the prognostic ability of each score by concordance index. At a median follow-up period of 28.8 months, the median progression-free survival (PFS) was 35.1 months and the median overall survival (OS) was not reached. Kaplan-Meier analysis showed significant differences for all scores except between IMDC and C-PLAN (PFS) and IMDC and mGPS (OS). Among these, PMHI and RMH demonstrated superior results in the C-index. ROC analysis showed no score had prognostic value for PD or ORR.

PMHI and RMH may be useful prognostic scores for survival outcomes in mRCC patients treated with immunotherapy. However, their ability to predict treatment efficacy (ORR and PD) is limited and further research is needed.