The treatment options for metastatic renal cell carcinoma (RCC) have changed considerably over the past 10 years with the introduction of immunotherapies, such as nivolumab, ipilimumab and pembrolizumab. However, with the new treatments comes the challenge of selecting the most effective treatment for each individual patient. Clinicians are constantly looking for ways to discover which patients are going to respond to therapy and those who are not.

Currently, the gold standard for grouping patients for treatment is the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) criteria. But the IMDC risk group criteria were first developed when anti-vascular endothelial growth factor (VEGF) therapy was the treatment of choice for metastatic RCC, and before the availability of immunotherapy.

In a recent paper published in The Oncologist in December 2019, a novel risk score based on body mass index, monocyte-to-lymphocyte ratio, and the number and sites of metastasis was described that could one day predict survival for patients with metastatic RCC on immunotherapy.

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