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    Patent Pending

    Memorial Sloan-Kettering Cancer Center (MSKCC/Motzer) Score for Metastatic Renal Cell Carcinoma (RCC)

    Predicts survival based on clinical and laboratory data in metastatic RCC patients.
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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.

    • Always correct calcium concentration for low albumin before scoring.

    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with metastatic RCC undergoing systemic therapy and being considered for clinical trial enrollment, and in clinical practice for the estimation of prognosis.

    • May assist in estimating prognosis of patients with metastatic RCC, but is not currently used for making decisions about treatment (use IMDC Risk Model instead).

    • Easy to use and uses readily available clinical and laboratory variables.

    Assists clinicians in discussions about prognosis for patients with metastatic RCC and can be used as a stratification factor in clinical trials.

    No
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    Yes
    +1
    No
    0
    Yes
    +1
    No
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    Yes
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    No
    0
    Yes
    +1
    No
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    +1

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights

    Management

    The score is currently not used for treatment decision-making. The IMDC Risk Model, which was originally based on the MSKCC/Motzer score, is currently used in treatment decision-making for metastatic RCC (NCCN Guidelines 2019).

    Critical Actions

    Can only be applied to patients with metastatic RCC that receive systemic therapy.

    Formula

    Addition of selected points, as above.

    Facts & Figures

    Interpretation:

    Score Risk

    Median survival

    0

    Good

    20 months
    1 - 2

    Intermediate

    10 months
    ≥3

    High

    4 months

    Evidence Appraisal

    The MSKCC/Motzer score in its current form was initially derived from a 2002 retrospective study reviewing data from 463 patients, who had been enrolled in six clinical trials, with metastatic RCC treated with first-line interferon-alpha. The five variables that make up the model were found to be significantly related to overall survival on multivariable analysis (Motzer 2002).

    Multiple external validation studies were subsequently conducted on modified versions of the model either in the first-line setting (Mekhail 2005) or in the second-line setting in the pre-targeted therapy era (Motzer 2004). Furthermore, Heng et al (2013) validated the original MSKCC Model and compared it to other similar models in the targeted therapy era. However, this study suggested that the IMDC Risk Model has superior prognostic power over the MSKCC model. Although the two models were found to be highly concordant, the IMDC model showed better fit and reclassification accuracy.

    The MSKCC risk group is still among the most frequently used risk models for metastatic RCC, and is often reported along with the IMDC model in clinical trials.

    Literature

    Validation

    Research PaperMotzer RJ, Bacik J, Murphy BA, Russo P, Mazumdar M. Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol 2002 Jan 1;20(1):289-96.Research PaperMotzer RJ, Bacik J, Schwartz LH, et al. Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma. J Clin Oncol. 2004;22(3):454-63.Research PaperMekhail TM, Abou-Jawde RM, Boumerhi G, Malhi S, Wood L, Elson P, Bukowski R. Validation and extension of the Memorial Sloan-Kettering prognostic factors model for survival in patients with previously untreated metastatic renal cell carcinoma. J Clin Oncol 2005 Feb 1;23(4):832-41.Research PaperMotzer RJ, Hutson TE, Tomczak P, et al. Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol. 2009;27(22):3584-90.Research PaperHeng DY, Xie W, Regan MM, et al. External validation and comparison with other models of the International Metastatic Renal-Cell Carcinoma Database Consortium prognostic model: a population-based study. Lancet Oncol. 2013;14(2):141-8.
    Dr. Robert J. Motzer

    About the Creator

    Robert J. Motzer, MD, is a medical oncologist at Memorial Sloan Kettering Cancer Center. He received the Career Development Award from the National Institutes of Health and the Schonfeld Award from the Kidney Cancer Association. Dr. Motzer’s research focuses on renal cell carcinoma, germ-cell tumors, and bone marrow and blood cell transplantation.

    To view Dr. Robert J. Motzer's publications, visit PubMed

    Content Contributors
    Reviewed By
    • Toni Choueiri, MD
    About the Creator
    Dr. Robert J. Motzer
    Content Contributors
    Reviewed By
    • Toni Choueiri, MD