IMDC risk groups (favourable / intermediate / poor)
The IMDC score uses six factors to sort metastatic kidney cancer into three risk groups. It decides whether dual immunotherapy or immunotherapy plus a targeted pill is offered first.
International Metastatic RCC Database Consortium (Heng) criteria: Karnofsky <80%, <1 year from diagnosis to treatment, anaemia, hypercalcaemia, neutrophilia, thrombocytosis. 0 factors favourable, 1-2 intermediate, ≥3 poor. Nivolumab-ipilimumab's OS benefit is confined to intermediate/poor risk; IO-TKI doublets benefit all groups on PFS, with less clear OS benefit in favourable risk.
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