Gustave Roussy Immune Score and Royal Marsden Hospital Prognostic Score Are Prognostic Markers for Extensive Disease of Small Cell Lung Cancer

Abstract

Background: The Royal Marsden Hospital prognostic score (RMH score) and the Gustave Roussy immune score (GRIm-score) were developed in order to select more suitable patient for phase I trials. Lactate dehydrogenase (LDH) and serum albumin concentration are common risk factors to these two systems. As the third risk factor, the RMH score and the GRIm-score adopt number of metastatic sites and neutrophil-to-lymphocyte ratio (NLR), respectively. We aimed to investigate whether these two systems are also useful for extensive disease of small cell lung cancer (ED-SCLC). Methods: We retrospectively collected 128 patients who had initiated platinum-based chemotherapy at our hospital between September 2007 and March 2018. We divided our patients into low (score 0-1) and high (2-3) score groups, and compared overall survival (OS) and progression-free survival (PFS) between them. Multivariate Cox proportional hazard analyses found prognostic factors of survival times. Results: Regarding GRIm-score, OS was significantly shorter in high score group than in low score group (median 6.1 vs. 11.4 months, P < 0.01), while no significant difference was observed in PFS (median 4.7 vs. 5.0 months, P = 0.12). Both OS (median 6.9 vs. 12.4 months, P < 0.01) and PFS (median 4.4 vs. 5.4 months, P = 0.01) were significantly shorter in high RMH score group than in low group. Multivariate analyses detected both high GRIm-score (hazard ratio (HR) 1.80, 95% confidence interval (CI) 1.20-2.72, P < 0.01) and high RMH score (HR 1.93, 95% CI 1.27-2.92, P < 0.01) as independent worse prognostic factors of OS, and then only high RMH score (HR 1.53, 95% CI 1.04-2.25, P = 0.03) as independent worse prognostic factor of PFS. Conclusions: Both RMH score and GRIm-score are useful as independent prognostic factors of OS in ED-SCLC. However, only RMH score is an independent prognostic factor of PFS.

Sarcopenia and Visceral Adiposity Are Not Independent Prognostic Markers for Extensive Disease of Small-Cell Lung Cancer: A Single-Centered Retrospective Cohort Study

“…This study retrospectively collected 128 patients ( Supplementary Material 1 , www.wjon.org ). This cohort was the same as that of our previous study [ 12 ]. The inclusion criteria were as follows: 1) Cytologically or histologically SCLC; 2) The first-line, cisplatin (CDDP) or carboplatin (CBDCA)-containing chemotherapy which had been initiated between September 2007 and March 2018 at Osaka Police Hospital; 3) Clinical stage IIIB or IV in the seventh lung cancer tumor-node-metastasis (TNM) classification and staging system published by the International Union Against Cancer (UICC) [ 13 ]; 4) Abdominal plain or enhanced computed tomography (CT) scan covering L3 level within 3 months, serum albumin concentration (mg/dL) and lactate dehydrogenase (LDH) (IU/L) in peripheral venous blood sampling within 2 weeks before the initiation of the first-line chemotherapy; and 5) No indication for curative-intent thoracic radiotherapy.…”

Prognostic value of modified-Gustave-Roussy Immunity Score in resectable proximal gastric cancer

“…Consistent with it is the Seigo Minami. [ 16 ] Studies in small cell lung cancer have found that OS was significantly shorter in high GRIm-score group than in low group (median 6.1 vs 11.4 months, P < .01). They also confirmed the high GRIm-score (HR 1.80, 95% CI 1.20–2.72, P < .01), as separate and prognostic factors of OS.…”

“…[ 15 ] The GRIm score is widely used in clinical immunotherapy or non-immunotherapy for various solid tumors, such as small cell lung cancer. [ 16 ] non-small cell lung cancer [ 12 , 17 ] and esophageal cancer, [ 18 ] and its role of prognosis evaluation has been confirmed. Studies show that a high GRIm score before treatment predicts worse overall survival (OS) and progression-free survival (PFS).…”

Prognostic Significance of the Royal Marsden Hospital (RMH) Score in Patients with Cancer: A Systematic Review and Meta-Analysis

“…They found that patients with a low RMH score (0-1) had a significantly longer median overall survival (OS) of 33 weeks compared to 15.7 weeks for patients with a high RMH score (2)(3). After that, the prognostic value of the RMH score for predicting outcomes was explored for various cancers on phase 1 trial cohorts, as well as a few cohorts from real-world settings [8,9]. However, this raises questions about the RMH score's generalizability in clinical trials to the larger and more variable patient populations encountered in daily clinical practice, necessitating a review of the available evidence.…”