BACKGROUND: The modified Glasgow prognostic score (mGPS), a clinical tool that incorporates albumin and C-reactive protein, has proven useful in the prognostication of multiple cancers. Several immune checkpoint inhibitors (ICIs) have been approved for the treatment of metastatic urothelial cell carcinoma (mUC), but a prognostic biomarker is needed. We investigated the impact of mGPS on survival outcomes in patients with mUC receiving ICIs. MATERIALS AND METHODS: We retrospectively reviewed patients with mUC treated with ICIs (programmed cell death protein 1 or programmed cell death ligand 1 inhibitors) at Winship Cancer Institute from 2015 to 2018. Overall survival (OS) and progression-free survival (PFS) were measured from the start date of ICI until death or clinical or radiographic progression, respectively. mGPS was defined as a summary score with one point given for C-reactive protein >10 mg/L and/or albumin <3.5 g/dL. Univariate (UVA) and multivariate (MVA) analyses were carried out using Cox proportional hazard model. These outcomes were also assessed by Kaplan-Meier analysis. RESULTS: A total of 53 patients were included with a median follow-up 27.1 months. The median age was 70 years, with 84.9% male and 20.8% Black. Baseline mGPS was 0 in 43.4%, 1 in 28.3% and 2 in 28.3%. Increased mGPS at the time of ICI initiation was associated with poorer OS and PFS in UVA, MVA, and Kaplan-Meier analyses. CONCLUSION: The mGPS may be a useful prognostic tool in patients with mUC when treatment with ICI is under consideration. These results warrant a larger study for validation. IMPLICATIONS FOR PRACTICE: The ideal prognostic tool for use in a busy clinical practice is easy-to-use, cost-effective, and capable of accurately predicting clinical outcomes. There is currently no universally accepted risk score in metastatic urothelial cell carcinoma (mUC), particularly in the immunotherapy era. The modified Glasgow prognostic score (mGPS) incorporates albumin and C-reactive protein and may reflect underlying chronic inflammation, a known risk factor for resistance to immune checkpoint inhibitors (ICIs). This study found that baseline mGPS is associated with survival outcomes in patients with mUC treated with ICIs and may help clinicians to prognosticate for their patients beginning immunotherapy.
BACKGROUND: The modified Glasgow prognostic score (mGPS), a clinical tool that incorporates albumin and C-reactive protein, has proven useful in the prognostication of multiple cancers. Several immune checkpoint inhibitors (ICIs) have been approved for the treatment of metastatic urothelial cell carcinoma (mUC), but a prognostic biomarker is needed. We investigated the impact of mGPS on survival outcomes in patients with mUC receiving ICIs. MATERIALS AND METHODS: We retrospectively reviewed patients with mUC treated with ICIs (programmed cell death protein 1 or programmed cell death ligand 1 inhibitors) at Winship Cancer Institute from 2015 to 2018. Overall survival (OS) and progression-free survival (PFS) were measured from the start date of ICI until death or clinical or radiographic progression, respectively. mGPS was defined as a summary score with one point given for C-reactive protein >10 mg/L and/or albumin <3.5 g/dL. Univariate (UVA) and multivariate (MVA) analyses were carried out using Cox proportional hazard model. These outcomes were also assessed by Kaplan-Meier analysis. RESULTS: A total of 53 patients were included with a median follow-up 27.1 months. The median age was 70 years, with 84.9% male and 20.8% Black. Baseline mGPS was 0 in 43.4%, 1 in 28.3% and 2 in 28.3%. Increased mGPS at the time of ICI initiation was associated with poorer OS and PFS in UVA, MVA, and Kaplan-Meier analyses. CONCLUSION: The mGPS may be a useful prognostic tool in patients with mUC when treatment with ICI is under consideration. These results warrant a larger study for validation. IMPLICATIONS FOR PRACTICE: The ideal prognostic tool for use in a busy clinical practice is easy-to-use, cost-effective, and capable of accurately predicting clinical outcomes. There is currently no universally accepted risk score in metastatic urothelial cell carcinoma (mUC), particularly in the immunotherapy era. The modified Glasgow prognostic score (mGPS) incorporates albumin and C-reactive protein and may reflect underlying chronic inflammation, a known risk factor for resistance to immune checkpoint inhibitors (ICIs). This study found that baseline mGPS is associated with survival outcomes in patients with mUC treated with ICIs and may help clinicians to prognosticate for their patients beginning immunotherapy.
Authors: Mehmet Asim Bilen; Giselle Marie Almeida Dutcher; Yuan Liu; Deepak Ravindranathan; Haydn T Kissick; Bradley C Carthon; Omer Kucuk; Wayne B Harris; Viraj A Master Journal: Clin Genitourin Cancer Date: 2018-01-04 Impact factor: 2.872
Authors: Guru Sonpavde; Gregory R Pond; Jonathan E Rosenberg; Dean F Bajorin; Toni K Choueiri; Andrea Necchi; Giuseppe Di Lorenzo; Joaquim Bellmunt Journal: J Urol Date: 2015-08-17 Impact factor: 7.450
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Authors: Mehmet A Bilen; Dylan J Martini; Yuan Liu; Colleen Lewis; Hannah H Collins; Julie M Shabto; Mehmet Akce; Haydn T Kissick; Bradley C Carthon; Walid L Shaib; Olatunji B Alese; Rathi N Pillai; Conor E Steuer; Christina S Wu; David H Lawson; Ragini R Kudchadkar; Bassel F El-Rayes; Viraj A Master; Suresh S Ramalingam; Taofeek K Owonikoko; R Donald Harvey Journal: Cancer Date: 2018-10-17 Impact factor: 6.860
Authors: Dylan J Martini; Yuan Liu; Julie M Shabto; Bradley C Carthon; Emilie Elise Hitron; Greta Anne Russler; Sarah Caulfield; Haydn T Kissick; Wayne B Harris; Omer Kucuk; Viraj A Master; Mehmet Asim Bilen Journal: Oncologist Date: 2019-12-05
Authors: Mehmet Asim Bilen; Dylan J Martini; R Donald Harvey; Viraj A Master; Yuan Liu; Julie M Shabto; Jacqueline T Brown; Milton Williams; Amir I Khan; Alexandra Speak; Colleen Lewis; Hannah Collins; Haydn T Kissick; Bradley C Carthon; Mehmet Akce; Walid L Shaib; Olatunji B Alese; Rathi N Pillai; Conor E Steuer; Christina S Wu; David H Lawson; Ragini R Kudchadkar; Bassel F El-Rayes; Suresh S Ramalingam; Taofeek K Owonikoko Journal: Oncologist Date: 2019-12-05
Authors: 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; Haydn Kissick; Kenneth Ogan; Bassel Nazha; Bradley C Carthon; Omer Kucuk; Wayne B Harris; Viraj A Master; Mehmet Asim Bilen Journal: J Immunother Cancer Date: 2021-07 Impact factor: 13.751