Assessment of the albumin-bilirubin grade as a prognostic factor in patients with non-small-cell lung cancer receiving anti-PD-1-based therapy

ESMO Open

article

K. Takada¹  S. Takamori²  M. Shimokawa³  G. Toyokawa⁵  S. Shimamatsu¹  F. Hirai¹  T. Tagawa⁶  T. Okamoto²  M. Hamatake¹  Y. Tsuchiya-Kawano⁷  K. Otsubo⁷  K. Inoue⁷  Y. Yoneshima⁸  K. Tanaka⁸  I. Okamoto⁸  Y. Nakanishi⁷  M. Mori⁶ 

[1] Department of Thoracic Surgery, Kitakyushu Municipal Medical Center;Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center;Department of Biostatistics, Yamaguchi University Graduate School of Medicine;Clinical Research Institute, National Hospital Organization Kyushu Cancer Center;Department of Thoracic Surgery, National Hospital Organization Kyushu Medical Center;Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University;Department of Respiratory Medicine, Kitakyushu Municipal Medical Center;Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University

关键词: albumin-bilirubin grade;    nivolumab;    non-small-cell lung cancer;    pembrolizumab;    prognostic factor;   

DOI  :  10.1016/j.esmoop.2021.100348

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Introduction The albumin-bilirubin (ALBI) grade is a novel indicator of the liver function. Some studies showed that the ALBI grade was a prognostic and predictive biomarker for the efficacy of chemotherapy in cancer patients. The association between the ALBI grade and outcomes in patients with non-small-cell lung cancer (NSCLC) treated with cancer immunotherapy, however, is poorly understood.Methods We retrospectively enrolled 452 patients with advanced or recurrent NSCLC who received anti-programmed cell death protein 1 (PD-1)-based therapy between 2016 and 2019 at three medical centers in Japan. The ALBI score was calculated from albumin and bilirubin measured at the time of treatment initiation and was stratified into three categories, ALBI grade 1-3, with reference to previous reports. We examined the clinical impact of the ALBI grade on the outcomes of NSCLC patients receiving anti-PD-1-based therapy using Kaplan–Meier survival curve analysis with log-rank test and Cox proportional hazards regression analysis.Results The classifications of the 452 patients were as follows: grade 1, n = 158 (35.0%); grade 2, n = 271 (60.0%); and grade 3, n = 23 (5.0%). Kaplan–Meier survival curve analysis showed that the ALBI grade was significantly associated with progression-free survival and overall survival. Moreover, Cox regression analysis revealed that the ALBI grade was an independent prognostic factor for progression-free survival and overall survival.Conclusion The ALBI grade was an independent prognostic factor for survival in patients with advanced or recurrent NSCLC who receive anti-PD-1-based therapy. These findings should be validated in a prospective study with a larger sample size.

【 授权许可】

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