Evidence map›Paper›PMID 34326170›Full record

ArticleJournal for immunotherapy of cancer2021

Modified Glasgow Prognostic Score associated with survival in metastatic renal cell carcinoma treated with immune checkpoint inhibitors.

Jacqueline T Brown, Yuan Liu, Julie M Shabto, Dylan Martini, Deepak Ravindranathan, Emilie Elise Hitron, Greta Anne Russler, Sarah Caulfield, Lauren Yantorni, Shreyas Subhash Joshi and 8 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal for immunotherapy of cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 1 institution in 1 country.

Jacqueline T BrownWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Yuan LiuWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Julie M ShabtoWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Dylan MartiniWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Deepak RavindranathanWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Emilie Elise HitronWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Greta Anne RusslerWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Sarah CaulfieldWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Lauren YantorniWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Shreyas Subhash JoshiWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Haydn KissickWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Kenneth OganWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Bassel NazhaWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Bradley C CarthonWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Omer KucukWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Wayne B HarrisWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Viraj A MasterWinship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Mehmet Asim BilenWinship Cancer Institute of Emory University, Atlanta, Georgia, USA mehmet.a.bilen@emory.edu.ORCID 0000-0003-4003-1103
Emory University · US

Funding

Winship Cancer Institute Cancer Center Support GrantP30CA138292 · NCI · EMORY UNIVERSITY · PI Suresh S Ramalingam · 2009 to 2026
$47.5M
NCI NIH HHS P30 CA138292
6 · The paper itself

Abstract

backgroundThe modified Glasgow Prognostic Score (mGPS) is a composite biomarker that uses albumin and C reactive protein (CRP). There are multiple immune checkpoint inhibitor (ICI)-based combinations approved for metastatic renal cell carcinoma (mRCC). We investigated the ability of mGPS to predict outcomes in patients with mRCC receiving ICI.

methodsWe retrospectively reviewed patients with mRCC treated with ICI as monotherapy or in combination at Winship Cancer Institute between 2015 and 2020. Overall survival (OS) and progression-free survival (PFS) were measured from the start date of ICI until death or clinical/radiographical progression, respectively. The baseline mGPS was defined as a summary score based on pre-ICI values with one point given for CRP>10 mg/L and/or albumin<3.5 g/dL, resulting in possible scores of 0, 1 and 2. If only albumin was low with a normal CRP, no points were awarded. Univariate analysis (UVA) and multivariate analysis (MVA) were carried out using Cox proportional hazard model. Outcomes were also assessed by Kaplan-Meier analysis.

results156 patients were included with a median follow-up 24.2 months. The median age was 64 years and 78% had clear cell histology. Baseline mGPS was 0 in 36%, 1 in 40% and 2 in 24% of patients. In UVA, a baseline mGPS of 2 was associated with shorter OS (HR 4.29, 95% CI 2.24 to 8.24, p<0.001) and PFS (HR 1.90, 95% CI 1.20 to 3.01, p=0.006) relative to a score of 0; this disparity in outcome based on baseline mGPS persisted in MVA. The respective median OS of patients with baseline mGPS of 0, 1 and 2 was 44.5 (95% CI 27.3 to not evaluable), 15.3 (95% CI 11.0 to 24.2) and 10 (95% CI 4.6 to 17.5) months (p<0.0001). The median PFS of these three cohorts was 6.7 (95% CI 3.6 to 13.1), 4.2 (95% CI 2.9 to 6.2) and 2.6 (95% CI 2.0 to 5.6), respectively (p=0.0216). The discrimination power of baseline mGPS to predict survival outcomes was comparable to the IMDC risk score based on Uno's c-statistic (OS: 0.6312 vs 0.6102, PFS: 0.5752 vs 0.5533).

conclusionThe mGPS is prognostic in this cohort of patients with mRCC treated with ICI as monotherapy or in combination. These results warrant external and prospective validation.

Indexed as

Carcinoma, Renal CellFemaleGlasgow Outcome ScaleHumansImmune Checkpoint InhibitorsKidney NeoplasmsMaleMiddle AgedNeoplasm MetastasisRetrospective StudiesImmune Checkpoint Inhibitorsimmunotherapyinflammation mediatorstumor biomarkerstumor microenvironmenturological neoplasms

Identifiers

PMID34326170
PMCPMC8323383
OpenAlexW3183656075

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.