{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:16:51Z","timestamp":1788542211779,"version":"build-2803163510"},"reference-count":32,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The modified Glasgow Prognostic Score (mGPS)\u2014a composite of serum C-reactive protein (CRP) and albumin\u2014simultaneously reflects systemic inflammatory activity and nutritional reserve. Its specific prognostic role in patients with metastatic renal cell carcinoma (mRCC) treated with nivolumab in the second-line setting has not previously been examined in a large multicentre cohort. The aims of this study are to determine whether baseline mGPS independently predicts overall survival (OS) and progression-free survival (PFS) in this population and whether its discriminatory capacity compares favourably with the International Metastatic RCC Database Consortium (IMDC) risk score. Methods: This multicentre retrospective cohort study included 174 consecutive patients with histopathologically confirmed mRCC who progressed on first-line VEGF-targeted tyrosine kinase inhibitor (TKI) therapy and subsequently received nivolumab monotherapy at six oncology centres in T\u00fcrkiye between January 2015 and December 2023. Baseline mGPS was calculated from serum albumin and CRP measured within four weeks before treatment initiation. Kaplan\u2013Meier analysis with log-rank testing and Cox proportional-hazards regression were used for survival analyses; discriminatory capacity was quantified using Uno\u2019s concordance (C) statistic. Results: The median follow-up was 24.2 months. The median OS was 44.5, 15.3, and 10.0 months for the mGPS 0, 1, and 2 groups, respectively (log-rank p &lt; 0.0001); the median PFS was 6.7, 4.2, and 2.6 months (p = 0.022). On multivariable analysis, mGPS 2 independently predicted inferior OS (hazard ratio [HR] 3.61, 95% confidence interval [CI] 1.78\u20137.31; p &lt; 0.001) and PFS (HR 1.87, 95% CI 1.17\u20132.97; p = 0.008). Uno\u2019s C-statistic for OS was numerically higher for the combined mGPS + IMDC model (0.70) than for either the mGPS (0.66) or IMDC (0.63) alone; these differences were not formally tested and are presented descriptively. Conclusions: Baseline mGPS is a simple, inexpensive, and independent prognostic biomarker in mRCC patients treated with second-line nivolumab, providing discriminatory information that may be complementary alongside IMDC risk stratification. Prospective validation in randomised trials is warranted.<\/jats:p>","DOI":"10.3390\/medicina62091675","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T01:05:26Z","timestamp":1788224726000},"page":"1675","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Value of the Modified Glasgow Prognostic Score in Patients with Metastatic Renal Cell Carcinoma Receiving Nivolumab as Second-Line Therapy: A Multicentre Retrospective Cohort Study"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1053-0668","authenticated-orcid":false,"given":"Sedat","family":"Biter","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Kahramanmara\u015f Necip Faz\u0131l City Hospital, Kahramanmaras 46050, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8713-7613","authenticated-orcid":false,"given":"Ertu\u011frul","family":"Bayram","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, \u00c7ukurova University, Adana 01330, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tolga","family":"K\u00f6\u015feci","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, \u00c7ukurova University, Adana 01330, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7857-6902","authenticated-orcid":false,"given":"Mehmet Cihan","family":"\u0130\u00e7li","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara 06230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6126-4611","authenticated-orcid":false,"given":"Ahmet Melih","family":"Arslan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Dokuz Eyl\u00fcl University, Izmir 35340, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2863-3243","authenticated-orcid":false,"given":"Faruk Recep","family":"\u00d6zalp","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Dokuz Eyl\u00fcl University, Izmir 35340, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7312-3827","authenticated-orcid":false,"given":"Nadiye","family":"Sever","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Marmara University Pendik Training and Research Hospital, Istanbul 34899, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8625-0761","authenticated-orcid":false,"given":"Ahmet","family":"\u00dcnsal","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Yeditepe University, Istanbul 34755, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2575-5819","authenticated-orcid":false,"given":"Nargiz Majidova","family":"Altunta\u015f","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, VM Medicalpark Maltepe Hospital, Istanbul 34846, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4841-7994","authenticated-orcid":false,"given":"Mustafa","family":"Seyyar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Gaziantep City Hospital, Gaziantep 27470, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fclhan","family":"Din\u00e7","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hatay Training and Research Hospital, Hatay 31060, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6356-9059","authenticated-orcid":false,"given":"Mahmut","family":"B\u00fcy\u00fck\u015fim\u015fek","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University of Health Sciences, Adana City Training and Research Hospital, Adana 01260, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4163-917X","authenticated-orcid":false,"given":"Mehmet","family":"T\u00fcrker","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University of Health Sciences, Adana City Training and Research Hospital, Adana 01260, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u015eenda\u011f","family":"Yasl\u0131kaya","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Giresun Training and Research Hospital, Giresun 28200, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4750-720X","authenticated-orcid":false,"given":"Mehmet Mutlu","family":"K\u0131d\u0131","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Seyhan State Hospital, Adana 01150, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2435-368X","authenticated-orcid":false,"given":"Yasemin","family":"Ayd\u0131nalp Camadan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University of Health Sciences, \u015eanl\u0131urfa Mehmet Akif \u0130nan Training and Research Hospital, Sanl\u0131urfa 63300, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umut","family":"Kefeli","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Kocaeli 41380, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8596-4233","authenticated-orcid":false,"given":"Mehmet","family":"Uzun","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University of Health Sciences, \u0130zmir Tepecik Training and Research Hospital, Izmir 35180, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3060-377X","authenticated-orcid":false,"given":"Hasan \u00c7a\u011fr\u0131","family":"Y\u0131ld\u0131r\u0131m","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Ege University, Izmir 35100, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7083-8517","authenticated-orcid":false,"given":"H\u00fcseyin Salih","family":"Semiz","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Dokuz Eyl\u00fcl University, Izmir 35340, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Erman","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara 06230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4963-2028","authenticated-orcid":false,"given":"\u0130smail O\u011fuz","family":"Kara","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, \u00c7ukurova University, Adana 01330, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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