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Multicenter Study
. 2025 Jan-Dec:24:15330338251316626.
doi: 10.1177/15330338251316626.

Prognostic Value of G8 Geriatric Screening and Meet-URO Scores in Metastatic Renal Cell Carcinoma Patients Receiving First-Line Ipilimumab-Nivolumab Combination Immunotherapy

Ria Nagpal  1 , Marina Campione  2 , Sara Elena Rebuzzi  3 , Lucia Fratino  4 , Pasquale Rescigno  5   6 , Sergio Bracarda  7 , Davide Bimbatti  8 , Ugo De Giorgi  9 , Matteo Santoni  10 , Fabio Calabrò  11 , Mimma Rizzo  12 , Alessio Signori  13 , Diana Giannarelli  14 , Giuseppe Fornarini  15 , Umberto Basso  8 , Giuseppe Luigi Banna  1   16
Affiliations
Multicenter Study

Prognostic Value of G8 Geriatric Screening and Meet-URO Scores in Metastatic Renal Cell Carcinoma Patients Receiving First-Line Ipilimumab-Nivolumab Combination Immunotherapy

Ria Nagpal et al. Technol Cancer Res Treat. 2025 Jan-Dec.

Abstract

Background: The prognostic value of the Geriatric 8 (G8) screening score in metastatic renal cell carcinoma (mRCC) patients receiving first-line immunotherapy remains unclear. This study aimed to evaluate the prognostic role of G8 within the context of the Meet-URO classification in mRCC patients treated with first-line ipilimumab-nivolumab.

Methods: This retrospective multicentre study analysed 106 mRCC patients treated with first-line ipilimumab-nivolumab. G8 and Meet-URO scores were calculated before treatment initiation. Primary endpoint was overall survival (OS), defined as duration from first administration of Nivolumab to death. OS was analysed in relation to age groups, G8 scores, and Meet-URO score categories, with data censored for patients still alive at the last follow-up. The secondary endpoint, progression-free survival (PFS), was measured from initiating Nivolumab to the earliest instance of disease progression or death. OS and PFS were assessed using Kaplan-Meier methods and Cox regression analyses. The reporting of this study conforms to the REMARK guidelines.

Results: Patients with G8 > 14 had more favorable IMDC and Meet-URO risk classifications and lower neutrophil-to-lymphocyte ratios. While PFS did not differ significantly between G8 ≤ 14 and >14 groups (1-year 29.3% vs 46.2%, p = 0.2), OS was significantly longer in G8 > 14 group (1-year 76.1% vs 58.6%, p = 0.006). In multivariable analysis, G8 ≤ 14 was independently associated with worse OS (HR 2.36, 95% CI 1.06-5.08, p = 0.03) but not PFS. The Meet-URO score was prognostic for both PFS and OS. In patients ≥70 years, G8 lost its prognostic value, while Meet-URO remained prognostic for OS.

Conclusions: The G8 score is an independent prognostic factor for OS but not PFS in mRCC patients receiving first-line ipilimumab-nivolumab. The Meet-URO score shows consistent prognostic ability for PFS and OS across age groups. These findings suggest that while G8 may be useful for individual patient-level OS prediction, the Meet-URO score may be superior for guiding treatment decisions in clinical practice.

Keywords: Elderly patients; G8; Immunotherapy; Ipilimumab; Meet-URO; Metastatic renal cell carcinoma; Nivolumab; Prognostic factors.

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Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SER received honoraria as a speaker at scientific events and travel accommodation from Amgen, GSK, BMS, MSD. DB received honoraria as speaker or advisory/board member from Ipsen, Astellas, Janssen, Novartis, MSD, Pfizer, Merck, Gentili and travel/accommodations/expenses from Ipsen, Janssen, MSD, Merck, Astrazeneca, Novartis. GLB reported personal fees from Astellas, Astrazeneca, Amgen, Bayer, Merck, Pfizer. UDG, financial interests, personal, advisory board: Pfizer, BMS, MSD, PharmaMar, Astellas, Bayer, Ipsen, Novartis, EISAI, Janssen; financial interests, personal, invited speaker: Roche, BMS, Clovis Oncology, AstraZeneca; financial interests, institutional, research grant: AstraZeneca, Sanofi, Roche. FC has received consulting fees from Merck Sharp & Dohme Oncology and Pfizer. MR received honoraria as a speaker/consultant by MSD, Bristol-Myers Squibb, Astrazeneca, Johnson & Johnson, Eisai, Gilead, Ipsen, Merck Serono and congress travel accommodation from Merck Serono, MSD, Johnson & Johnson, Ipsen. PR served as an advisory board for MSD and Astra Zeneca Italy. GF served as an advisory board member for Astellas, Janssen, Pfizer, Bayer, MSD, Merck and received travel accommodation from Astellas, Janssen, Bayer. DG served as an advisory board for Sanofi and received consulting fee from Amgen. All other authors have declared no conflicts of interest.

Figures

Figure 1.
Figure 1.
Diagram depicting patient flow through the study, highlighting both primary and secondary endpoints.
Figure 2.
Figure 2.
Progression-free and Overall Survival of the overall population (panels A and B) and according to G8 ≤ 14 (C and D).
Figure 3.
Figure 3.
Sankey diagram demonstrating association between the Meet-URO and the G8 score.
See this image and copyright information in PMC

References

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