IMDC (Heng) Score for Metastatic RCC
International Metastatic RCC Database Consortium criteria for systemic-therapy-treated mRCC (Heng 2009). Sums 6 adverse factors. Predicts overall survival on first-line therapy and stratifies for combination therapy decisions.
Score interpretation
→ First-line VEGF tyrosine-kinase inhibitor (pazopanib, tivozanib or sunitinib). NICE does not recommend lenvatinib + pembrolizumab for favourable-risk disease (TA858) or pembrolizumab + axitinib (TA650). Active surveillance can suit selected indolent oligometastatic disease.
→ Options recommended by NICE for IMDC intermediate/poor risk: nivolumab + ipilimumab, cabozantinib, or lenvatinib + pembrolizumab (TA858); TKI monotherapy remains an option. MDT discussion of cytoreductive nephrectomy timing.
→ As intermediate risk (nivolumab + ipilimumab, cabozantinib, or lenvatinib + pembrolizumab per NICE TA858). Cytoreductive nephrectomy not routinely recommended (CARMENA). Early supportive and palliative care; consider trials.
Interpretation bands for the IMDC. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Sodium Cromoglicate Nasal Spray · Mast Cell Stabiliser — Allergic Rhinitis
- Olopatadine · H1 antihistamine + mast cell stabiliser
- Hydroxycarbamide (Hydroxyurea) · Cytoreductive agent / Sickle cell disease / CML
- Crizanlizumab · P-selectin Inhibitor — Sickle Cell Disease
- Voxelotor · Haemoglobin S Polymerisation Inhibitor — Sickle Cell Disease
- Mosunetuzumab · CD20×CD3 Bispecific T-Cell Engager
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.