Introduction: Growing evidence suggests that a persistent systemic inflammatory response is associated with poorer survival outcomes in patients with malignant disease. The modified Glasgow Prognostic Score (mGPS), based on elevated C-reactive protein (CRP >10 mg/L) and hypoalbuminemia (10 mg/L, albumin ≥35 g/L), and mGPS 2 (CRP >10 mg/L, albumin <35 g/L). Overall survival (OS) and disease-free survival (DFS) were analyzed using Kaplan–Meier estimates. Treatment-related toxicity was assessed according to CTCAE criteria. Prognostic factors were evaluated using univariate Cox regression analyses. Results: Survival outcomes differed significantly across mGPS categories, with patients classified as mGPS 0 demonstrating the most favorable treatment response and survival. In univariate analysis, both mGPS (p < 0.0001) and tumor stage (p = 0.004) were significantly associated with prognosis. Response rates to immunotherapy varied markedly between groups (mGPS 0: 71%, mGPS 1: 34%, mGPS 2: 26%; p < 0.001). Higher mGPS values were also significantly associated with increased treatment-related and disease-related morbidity. Conclusion: Systemic inflammation and nutritional status, as reflected by the mGPS, are independent predictors of treatment response, toxicity, and survival in patients with mUC undergoing immunotherapy. Alongside established pathological markers, the mGPS represents an objective, low-cost, and readily available prognostic tool with potential clinical utility in routine practice.
Dräger et al. (Fri,) studied this question.