在 2 项回顾性分析中，将中性粒细胞与淋巴细胞比率 (NLR) 和骨转移添加到由 Meet-URO 评分提供的 IMDC 分类中，使接受≥二线纳武单抗或卡博替尼的转移性肾细胞癌 (mRCC) 患者的预后准确性更高以及扩大使用计划中的第一线纳武单抗-伊匹木单抗（nivolumab-ipilimumab）。老年 mRCC 患者的预后估计可能是临床决策的关键。在多中心观察性前瞻性 ZEBRA (Meet-URO 9) 研究中，对现实世界中老年（≥70 岁）mRCC 患者接受任何系列卡博替尼治疗的结果进行了分析到基线 Meet-URO 分数。主要终点是总生存期（OS）。通过 Harrell 的 c 指数和校准来评估判别能力，以比较 Meet-URO 和 IMDC 评分。 共有 104 名 mRCC 患者接受卡博替尼治疗，排名为第一（38%）、第二（20%）或≥第三（41%）线。中位随访时间为 11.2 个月，中位 OS (mOS) 为 18.4 个月。根据 IMDC 评分，有利 (15%)、中等 (65%) 和低风险 (19%) 患者的 mOS 未达到，分别为 15.6 和 5.7 个月 (p = .011)。根据 Meet-URO 评分分组，第 1 组 (10%) 和第 2 组 (25%) 均未达到 mOS，第 3 组 (33%)、第 4 组 (25%) 和第 5 组 (8%) 均未达到 mOS ) mOS 分别为 13.6、12.5 和 3.7 个月 (p < .001)。通过合并 1 至 2 组与 3 组至 4 组与 5 组来维持 Meet-URO 评分的辨别能力 (p < .001)。 Meet-URO 评分（原始 5 组分层或修改后的 3 组分层）显示出比 IMDC 评分更高的准确性（c 指数为 0.686 和 0.676 vs. 0.622）。该分析证实了使用卡博替尼治疗的老年 mRCC 患者的 Meet-URO 评分及其作为告知患者和临床决策的便捷工具的作用。版权所有 © 2023 Elsevier Inc. 保留所有权利。

The addition of neutrophil to lymphocyte ratio (NLR) and bone metastases to the IMDC classification provided by the Meet-URO score, resulted in higher prognostic accuracy in metastatic renal cell carcinoma (mRCC) patients receiving ≥2nd line nivolumab or cabozantinib in 2 retrospective analyses and 1st line nivolumab-ipilimumab in an expanded access programme. Prognostic estimates for older mRCC patients might be key for clinical decision-making.The outcome of real-world older (≥70 years) mRCC patients treated with any line cabozantinib within the multicenter observational prospective ZEBRA (Meet-URO 9) study was analyzed according to the baseline Meet-URO score. The primary endpoint was overall survival (OS). The discriminative ability by Harrell's c-index and calibration were assessed to compare the Meet-URO and IMDC scores.A total of 104 mRCC patients received cabozantinib as 1st (38%), 2nd (20%), or ≥3rd (41%) line. With a median follow-up of 11.2 months, the median OS (mOS) was of 18.4 months. According to the IMDC score, favorable (15%), intermediate (65%) and poor-risk (19%) patients had a mOS not reached, of 15.6 and 5.7 months respectively (p = .011). According to the Meet-URO score groups, mOS was not reached in both group 1 (10%) and group 2 (25%), while in group 3 (33%), group 4 (25%) and group 5 (8%) mOS was of 13.6, 12.5, and 3.7 months, respectively (p < .001). The discriminative ability of the Meet-URO score was maintained by merging groups 1 to 2 vs. 3 to 4 vs. 5 (p < .001). The Meet-URO score (with either the original 5-group stratification or the modified 3-group one) showed higher accuracy than the IMDC score (c-index of 0.686 and 0.676 vs. 0.622).This analysis confirmed the prognostic accuracy of the Meet-URO score in older mRCC patients treated with cabozantinib and its role as a convenient tool for informing the patient and clinical decisions.Copyright © 2023 Elsevier Inc. All rights reserved.