The Gustave Roussy immune score as a novel biomarker for predicting survival in patients with isocitrate dehydrogenase wild-type glioblastoma treated with the Stupp protocol.

BACKGROUND

Isocitrate dehydrogenase (IDH) wild-type (wt) glioblastoma is a biologically aggressive adult-type diffuse glioma with poor prognosis. Gustave Roussy Immune Score (GRIm-Score), reflecting systemic inflammation and nutritional status, has shown prognostic relevance in several cancers. Its prognostic value in IDH-wt glioblastoma remains undefined.

METHODS

This retrospective single-center study included 186 patients with histologically confirmed IDH-wt glioblastoma. GRIm-Score was calculated using pretreatment NLR, albumin, and lactate dehydrogenase (LDH) levels. Patients were grouped into low- and high-risk categories. Associations with overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan-Meier and Cox regression analyses. Correlations with other inflammation-based indices, such as PILE, CAR, and PIV, were also examined.

RESULTS

A high GRIm-Score was significantly associated with reduced OS and PFS. Patients with higher scores more frequently exhibited poor prognostic features, including advanced age, worse ECOG performance, limited treatment response, and subtotal resection. Multivariate analysis identified GRIm-Score as an independent prognostic factor, particularly when analyzed alongside CAR and PIV. Strong correlations were observed between GRIm-Score and other immuno-nutritional markers.

CONCLUSIONS

GRIm-Score is a simple and reliable prognostic indicator in IDH-wt glioblastoma. Its routine use may improve risk stratification and inform therapeutic decisions. Further prospective multicenter validation is warranted.