Prognostic Role of Modified Glasgow Prognostic Score in metastatic Renal Cell Carcinoma Patients Treated with Nivolumab: Single-Center Experience

Aim: This study aimed to evaluate the prognostic significance of the modified Glasgow Prognostic Score (mGPS) in patients with metastatic renal cell carcinoma (mRCC) treated with nivolumab monotherapy. Methods: We retrospectively analyzed 80 patients with mRCC who received at least one cycle of nivolumab between February 2016 and March 2024 at a single academic center. Patients were categorized into three groups according to pre-treatment mGPS (0, 1, or 2). Survival outcomes were assessed using the Kaplan–Meier method. Results: The median progression-free survival (mPFS) was 31.3, 6.8, and 4.4 months in patients with mGPS 0, 1, and 2, respectively (p = 0.001). The median overall survival (mOS) was 33.4 months for mGPS 0, 14.1 months for mGPS 1, and 6.7 months for mGPS 2 (p = 0.001). mGPS was significantly associated with both PFS and OS. Notably, patients with mGPS 0 had substantially better survival outcomes. These findings suggest a potential association between higher systemic inflammation (as reflected by mGPS) and adverse prognostic features. mGPS demonstrated partial overlap with the IMDC (International Metastatic RCC Database Consortium) classification but offered additional prognostic stratification due to its incorporation of inflammatory markers. Conclusion: mGPS is a simple, objective, and clinically applicable biomarker that may support survival prediction and patient selection in the context of ICI therapy for mRCC. Its integration into routine clinical decision-making could enhance personalized treatment strategies. Prospective studies in larger cohorts are needed to validate these findings.