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 tyrosine-kinase inhibitor (sunitinib / pazopanib) or IO + TKI combination (axitinib + pembrolizumab) per NICE TA858. Active surveillance possible in selected indolent oligometastatic disease.
→ Ipilimumab + nivolumab (NICE TA616) or IO + TKI combinations are preferred over TKI monotherapy. MDT discussion for cytoreductive nephrectomy timing.
→ Combination IO (ipilimumab-nivolumab) or IO + TKI as standard. Cytoreductive nephrectomy not routinely recommended (CARMENA). Aggressive supportive care, trial enrolment, palliative-care input early.
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.