Clinical calculator summary
Original 2017 Bigot Gustave Roussy Immune Score
Clinical calculator summary
Original 2017 Bigot Gustave Roussy Immune Score
A three-factor additive baseline prognostic score using albumin, LDH relative to local ULN, and NLR.
Evidence-based context for fast calculator use
- Purpose:
- Reproduce the original low- versus high-score phase-I cohort grouping and show its historical discovery-cohort observation.
- Population:
- Adults with mixed advanced solid tumors entering phase-I immune-checkpoint-therapy trials at baseline.
- Factors:
- Albumin <35 g/L, LDH above local laboratory ULN, NLR >6
- Reference:
- Bigot et al. Eur J Cancer. 2017;84:212-218.
GRIm Score
Clinical Context & Background
Original 2017 GRIm score = 1 point each for albumin <35 g/L, LDH above the local laboratory upper limit of normal, and NLR >6.Reference Data
| Score | Original group | Discovery-cohort median OS |
|---|---|---|
| 0-1 | Low group | 68.9 weeks |
| 2-3 | High group | 20.4 weeks |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use baseline pretreatment values for adults with advanced solid tumors entering phase-I immune-checkpoint-therapy trials resembling the original cohorts.
- Enter LDH and its local laboratory ULN in identical units; use the unrounded NLR.
How To Interpret
- Scores 0-1 form the original Low group; scores 2-3 form the High group.
- Albumin exactly 35 g/L, LDH exactly at ULN, and NLR exactly 6 each score zero.
What To Do Next
- Integrate the result with protocol criteria, performance status, disease status, organ function, comorbidity, patient goals, and specialist assessment.
- Do not select, withhold, or recommend immunotherapy because of GRIm alone.
Limitations
- The original cohorts contained mixed advanced solid tumors and were not lung-cancer-specific.
- Not validated for screening, diagnosis, early-stage disease, treatment response, or post-treatment reassessment.
- GRIm is prognostic and is not a validated prediction of immunotherapy benefit or a treatment-selection rule.
- No unsupported upper limits are imposed on the laboratory inputs.
Validated Population
Baseline adults with mixed advanced solid tumors entering the original phase-I immune-checkpoint-therapy trials.
Equality example
Albumin 35 g/L, LDH equal to its local ULN, and NLR 6 each score zero, producing a total score of 0.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed cases passed through visible production controls at GRIm scores 0, 1, and 3.
- Raw albumin, LDH/ULN, and NLR thresholds produced the expected Low and High groups.
- No unexpected N/A, literal undefined value, stale control, unsupported gauge, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/grim-immunotherapy-lung-cancer-score-2026-08-03.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
- Overall browser status: failed-console. medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/grim-immunotherapy-lung-cancer-score.json.
: Browser input adapter corrected and reverified
- Accepted finite number values already normalized by the shared calculator form while retaining strict malformed-input rejection.
- No equation, cutoff, unit, classification, or applicability rule changed; calculator-specific verification and the calculator-wide browser-input audit passed.
: Full validation test
- 320/320 independent model, exact-boundary, invalid-input, UI/integration, outcome, trace, wording, and immutability checks passed.
- No registered master panel calculates GRIm; no panel receives inherited GRIm verification.
: Calculation and input-contract correction
- Replaced favorable pre-scored defaults with required raw albumin, LDH, local LDH ULN, and NLR; missing, extra, coercive, nonfinite, and out-of-domain values are rejected.
- Restored exact equality behavior, complete contribution trace, original discovery-cohort median-survival rows, and mixed-solid-tumor prognostic scope without claiming individualized survival, immunotherapy benefit, or treatment selection.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Related Tools
Frequently Asked Questions
Does albumin exactly 35 g/L score a point?
No. The original adverse criterion is strictly below 35 g/L.
Do LDH exactly at ULN or NLR exactly 6 score points?
No. Both original adverse criteria are strict greater-than comparisons.
Does GRIm predict immunotherapy benefit?
No. It is a historical prognostic grouping and must not be used as a stand-alone treatment-selection or immunotherapy-benefit tool.
Evidence-based oncology decision support. Verify with clinical guidelines.