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      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

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    Patent Pending

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

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

    • Use baseline factors at the start date of the current line of systemic therapy, except for the “time of diagnosis to systemic therapy” criterion, which is always relative to first-line therapy.

    • Use limits of normal set by the laboratory performing the tests (for hemoglobin concentration, absolute neutrophil count, platelet count, corrected calcium concentration).

    • Always correct calcium concentration for low albumin before scoring.

    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with metastatic renal cell carcinoma.

    • 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.

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

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    Result:

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    Next Steps
    Evidence
    Creator Insights

    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.

    Content Contributors
    About the Creator
    Dr. Daniel Heng
    Are you Dr. Daniel Heng?
    Dr. Toni Choueiri
    Are you Dr. Toni Choueiri?
    Dr. Wanling Xie
    Are you Dr. Wanling Xie?
    Guidelines
    Content Contributors