Association of baseline modified Glasgow Prognostic Score (mGPS) with survival outcomes in patients with metastatic urothelial cell carcinoma (mUCC) treated with immune checkpoint inhibitors (CPI).

Abstract

563 Background: The mGPS, a clinical tool that incorporates albumin and C-reactive protein, has proven useful in the prognostication of multiple cancers. Several CPI agents have been approved for the treatment of mUCC but a prognostic biomarker is needed. We investigated the impact of mGPS on survival outcomes in mUCC patients receiving CPI. Methods: We retrospectively reviewed mUCC patients treated with CPI (PD-1 or PD-L1 inhibitors) at Winship Cancer Institute from 2015 to 2018. Overall survival (OS) and progression-free survival (PFS) were measured from the start date of CPI until death or clinical/radiographic progression, respectively. mGPS was defined as a summary score with one point given for CRP > 10 mg/L and/or albumin < 3.5 g/dL. Univariate (UVA) and multivariate (MVA) analyses were carried out using Cox proportional hazard model for OS and PFS. 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%. The correlation between mGPS and other inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR), was high with Pearson correlation coefficients ≥ 0.48 (p ≤ 0.0003). Increased mGPS at the time of CPI initiation was associated with poorer OS and PFS (Table). Conclusions: The mGPS may be a useful prognostic tool in mUCC patients when treatment with CPI is under consideration. These results warrant a larger study for validation.[Table: see text]