Open Access

Prognostic value of the pretreatment Glasgow prognostic score or modified Glasgow prognostic score in patients with advanced cancer receiving immune checkpoint inhibitors: A systematic review and meta‑analysis

  • Authors:
    • Lianghui Zhang
    • Lili Lin
    • Jie Ni
    • Tao Ling
    • Lingli Huang
  • View Affiliations

  • Published online on: May 2, 2025     https://doi.org/10.3892/ol.2025.15069
  • Article Number: 323
  • Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The Glasgow prognostic score (GPS) and modified GPS (mGPS) have value in evaluating the prognosis of patients receiving immune checkpoint inhibitors (ICIs). However, with the continuous emergence of new research, the predictive value of GPS and mGPS for immunotherapy deserves further validation. The aim of the present study was to explore the predictive value of GPS or mGPS on the progression‑free survival (PFS) and overall survival (OS) of patients with advanced cancer receiving ICIs. Eligible studies were systematically searched using the PubMed, Embase, Cochrane library and Web of Science databases until November 2022. Published data were extracted and the hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled. A total of 18 studies with 1,355 patients were included in the present study. Patients were divided into the low GPS/mGPS (0) and high GPS/mGPS (1/2/1‑2) groups. Overall, the high GPS group had a shorter OS (HR, 2.88; 95% CI, 2.06‑4.03) with high heterogeneity, and a shorter PFS (HR, 2.08; 95% CI, 1.55‑2.78) with low heterogeneity, compared with the low GPS group. Sensitivity analysis showed that the results were stable and the heterogeneity was significantly reduced from 56.4 to 30.3% after excluding one study. Subgroup analyses by score showed that GPS 1, GPS 2 and GPS 1‑2 all had a poorer OS than GPS 0, with low heterogeneity. Overall, the high mGPS group had a poorer OS (HR, 2.56; 95% CI, 1.76‑3.72) with low heterogeneity, and a poorer PFS (HR, 2.55; 95% CI, 1.81‑3.60) with high heterogeneity, compared with the low mGPS group. The combined effect size was consistent but the heterogeneity was not eliminated after sensitivity analysis. Subgroup analyses by country and score also showed that the country had no effect on the results and that mGPS 1, mGPS 2 and mGPS 1‑2 had a poorer PFS than mGPS 0. Therefore, high GPS and mGPS may be effective biomarkers for predicting the survival of patients with cancer receiving ICIs. Patients with high GPS and mGPS may be considered for supportive treatment; however, large prospective trials are needed to validate these findings.
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July-2025
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Spandidos Publications style
Zhang L, Lin L, Ni J, Ling T and Huang L: Prognostic value of the pretreatment Glasgow prognostic score or modified Glasgow prognostic score in patients with advanced cancer receiving immune checkpoint inhibitors: A systematic review and meta‑analysis. Oncol Lett 30: 323, 2025.
APA
Zhang, L., Lin, L., Ni, J., Ling, T., & Huang, L. (2025). Prognostic value of the pretreatment Glasgow prognostic score or modified Glasgow prognostic score in patients with advanced cancer receiving immune checkpoint inhibitors: A systematic review and meta‑analysis. Oncology Letters, 30, 323. https://doi.org/10.3892/ol.2025.15069
MLA
Zhang, L., Lin, L., Ni, J., Ling, T., Huang, L."Prognostic value of the pretreatment Glasgow prognostic score or modified Glasgow prognostic score in patients with advanced cancer receiving immune checkpoint inhibitors: A systematic review and meta‑analysis". Oncology Letters 30.1 (2025): 323.
Chicago
Zhang, L., Lin, L., Ni, J., Ling, T., Huang, L."Prognostic value of the pretreatment Glasgow prognostic score or modified Glasgow prognostic score in patients with advanced cancer receiving immune checkpoint inhibitors: A systematic review and meta‑analysis". Oncology Letters 30, no. 1 (2025): 323. https://doi.org/10.3892/ol.2025.15069