Abstract 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 first-line IO-TKI setting was awaited. Methods The Meet-URO 33 is a multicentric prospective observational study enrolling mRCC patients receiving first-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 A total of 1,557 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). Conclusions The Meet-URO score confirmed its better prognostic accuracy compared with the IMDC score, also in a large-scale prospective cohort receiving first-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.
Rebuzzi et al. (Fri,) studied this question.