Gustave Roussy Immune Score As a Prognostic Biomarker in Patients with Platinum-refractory Metastatic Urothelial Carcinoma Treated with Pembrolizumab: YUSHIMA Study

Overview

Journal Int J Clin Oncol

Specialty Oncology

Date 2024 Jun 4

PMID 38833113

Authors

Kenji Tanabe

Shuichiro Kobayashi

Yuya Maezawa

Kensaku Ishihara

Naoki Inoue

Keita Izumi

Motohiro Fujiwara

Masahiro Toide

Takanobu Yamamoto

Sho Uehara

Saori Araki

Masaharu Inoue

Ryoji Takazawa

Noboru Numao

Yukihiro Ohtsuka

Hajime Tanaka

Soichiro Yoshida

Yasuhisa Fujii

Affiliations

Soon will be listed here.

Abstract

Background: This study aimed to investigate the prognostic value of the Gustave Roussy Immune score (GRIm-score) in platinum-refractory metastatic urothelial carcinoma (UC) treated with pembrolizumab.

Methods: This multicenter retrospective study (YUSHIMA study) evaluated 331 patients with metastatic UC treated with pembrolizumab after platinum-based chemotherapy between January 2018 and June 2023 at 13 institutions. We collected pretreatment variables, including the GRIm-score based on serum albumin, lactate dehydrogenase, and neutrophil-to-lymphocyte ratio. The patients were divided into low and high GRIm-score groups. Prognostic factors for overall survival (OS) and progression-free survival (PFS) were determined using the multivariate Cox proportional hazard model.

Results: During the median follow-up period of 7.3 months, 278 (84%) patients showed disease progression, and 223 (67%) died from any cause. Multivariate analysis revealed that the high GRIm-score group was an independent and significant adverse prognostic factor of both OS and PFS (hazard ratio, 1.65 and 1.82, respectively; both p < 0.001) along with Eastern Cooperative Oncology Group Performance Status of ≥ 2 (both p < 0.001), presence of visceral metastasis (both p < 0.001), and hemoglobin of < 9.2 g/dL (p = 0.030 and p = 0.038). C-reactive protein of > 42 mg/L was a significant prognostic factor for OS (p = 0.001).

Conclusion: The GRIm-score is an independent prognostic marker for survival outcomes in patients with platinum-refractory metastatic UC treated with pembrolizumab.

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