IMDC (International Metastatic RCC Database Consortium) Risk Model for Metastatic Renal Cell Carcinoma

IMDC Risk Model for Metastatic RCC

Time from Diagnosis to Treatment < 1 Year

Karnofsky Performance Status < 80%

Hemoglobin < Lower Limit of Normal

Corrected Calcium > Upper Limit of Normal

Neutrophils > Upper Limit of Normal

Platelets > Upper Limit of Normal

IMDC Score: –

Awaiting input

Select all criteria to compute the score.

Predicts survival in patients with metastatic renal cell carcinoma treated with systemic therapy (also known as Heng criteria).

Why Use

Assists clinicians in discussions about prognosis and in deciding the appropriate systemic therapy for patients with metastatic renal cell carcinoma.

When to Use

Patients with metastatic renal cell carcinoma.

Formula

Addition of the selected points: Variable Points <1 year from time of diagnosis to systemic therapy 1 Karnofsky performance status <80% 1 Hemoglobin < lower limit of normal (usually ~120 g/L or 12 g/dL) 1 Corrected calcium > upper limit of normal (usually ~8.5-10.2 mg/dL) 1 Neutrophils > upper limit of normal (usually ~2.0-7.0×10⁹/L) 1 Platelets > upper limit of normal (usually ~150,000-400,000 cells/µL) 1

Pearls / Pitfalls

Validated in the following settings: Patients with clear cell and non-clear cell metastatic renal cell carcinoma. Patients undergoing targeted therapies and immune checkpoint inhibitor therapy. Multiple care settings: clinical trial patients, patients receiving standard of care therapy at community and academic centers, and across multiple countries. Can assist in the choice of systemic therapy. Easy to use, uses readily available clinical and laboratory variables, and compares favorably to other similar prognosis prediction models.

Management

According to NCCN guidelines (v3.2019) , choice of first-line systemic therapy for metastatic renal cell carcinoma based on risk group is: Intermediate or poor risk : ipilimumab plus nivolumab (Phase III trial evidence) or cabozantinib (Phase II trial evidence). Favorable risk : PAZOPanib or SUNItinib. Refer to AUA guidelines for further details on management of renal cancer.

Critical Actions

Can only be applied to patients with metastatic renal cell carcinoma that receive systemic therapy.

More Information

Interpretation: IMDC Risk Score Risk group Median survival 0 Favorable 43.2 months 1-2 Intermediate 22.5 months ≥3 Poor 7.8 months From Heng 2013 .