Prognostic role of the Glasgow prognostic score and modified Glasgow prognostic score in patients with renal cell carcinoma undergoing immunotherapy: a meta-analysis
In brief
High Glasgow prognostic score more than doubles death risk in RCC immunotherapy
In a meta-analysis of nine studies, renal cell carcinoma patients receiving immune checkpoint inhibitors with a high GPS or mGPS had about 2.5 times higher overall mortality and 1.8 times higher progression-free risk than those with low scores. The effect was strongest in metastatic disease and across continents, suggesting GPS/mGPS could help stratify patients, though prospective trials are needed.
- Journal
- Clinics (Sao Paulo, Brazil) (Q2)
- Published
- 17 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Xiangning Zhang, Xiaoye Li, Yajun Xie, Ning Shi
- PMID
- 42468376
- DOI
- 10.1016/j.clinsp.2026.101008
Why clinicians should know about it
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Abstract
BACKGROUND: Overall Survival (OS) in patients with urological cancers can be predicted by the Glasgow Prognostic Score (GPS) and modified GPS (mGPS). However, the predictive value of the GPS and mGPS in individuals with Renal Cell Carcinoma (RCC) receiving immunotherapy remains inconclusive. The present analysis examined how the GPS and mGPS predict prognosis in RCC patients treated with immunotherapy. METHODS: Studies available before March 18, 2025, were systematically searched in PubMed, Web of Science, Embase, and Cochrane. To determine prognostic effects in RCC, Hazard Ratios (HRs) and 95 % Confidence Intervals (95 % CIs) were estimated. RESULTS: This meta-analysis encompassed nine eligible studies. Patients with high GPS/mGPS (1/2/1‒2) had a significantly higher risk of death compared with those with low GPS/mGPS (0): OS (HR = 2.48; 95 % CI 2.05-2.99; p < 0.001) and Progression-Free Survival (PFS) (HR = 1.84; 95 % CI 1.61-2.11; p < 0.001). Subgroup analysis revealed that high-GPS/mGPS RCC patients in Asia (HR = 3.19; 95 % CI 1.63-6.23) and Europe (HR = 2.90; 95 % CI 2.25-3.74) had higher mortality risk compared with those in North America (HR = 1.88; 95 % CI 1.38-2.54). Furthermore, the prognostic impact of GPS/mGPS was more evident in metastatic patients (HR = 3.18; 95 % CI 2.43-4.14; p < 0.001) than in those without metastasis (HR = 1.94; 95 % CI 1.49-2.52; p < 0.001). mGPS-only analysis confirmed poor prognosis (HR = 2.56; 95 % CI 1.95-3.38; p < 0.001); metastatic burden drove heterogeneity (meta-regression p < 0.05). CONCLUSION: GPS/mGPS may serve as effective biomarkers for predicting survival in RCC patients receiving ICI therapy. High GPS and mGPS are associated with increased mortality risk. Further randomized controlled trials are warranted to explore the prognostic potential of GPS/mGPS.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.