The prognostic value of Meet-URO score in patients with metastatic clear cell renal cell carcinoma receiving second or third-line tyrosine kinase inhibitors/immune checkpoint inhibitors combination therapy: A real-world study.

e16516 Background: A novel prognostic predictive model based on inflammatory indices and clinical factors; Meet-URO Score has been validated in patients with metastatic clear cell renal cell carcinoma (mccRCC) receiving immunotherapy. Here we investigate its prognostic value in Clear Cell Renal Cell Carcinoma (ccRCC) patients receiving second and third-line tyrosine kinase inhibitors-immune checkpoint inhibitors (TKIs-IOs) combination treatment. Methods: Baseline and follow up data from patients with mccRCC were obtained retrospectively from a single institution. Neutrophil-to-lymphocyte ratio (NLR), the International Metastatic RCC Database Consortium (IMDC) score and bone metastases were assessed before treatment. The primary outcomes were overall survival (OS). Harrell’s c-index was estimated to compare the accuracy of the prediction ability of the two models and Cox proportional hazard-regression model was used for univariable and multivariable analyses. Results: A total or 72 patients received TKIs-IOs combination treatment as second- and third-line therapy (88.89% and 11.11%) were included in this study. A significant shorter median overall survival (mOS) was observed in the IMDC poor risk group. Applying Meet-URO score, four groups were found and stratified (p=0.0016). The c-index in Meet-URO was higher than in IMDC (0.676 vs 0.585) and indicated that Meet-URO score had a higher discriminative ability than the IMDC score. In the Cox regression model, nephrectomy was found to be a protective factor (HR=0.21, 95% confidence interval: 0.05 - 0.93, p=0.04). Conclusions: Meet-URO score presents more accurate prognostic stratification than the IMDC score in mccRCC patients receiving TKIs-IOs combination treatment as second or further line therapy. More research is necessary to validate these findings in the future.