Prognostic significance of pre-treatment ALBI grade in advanced non-small cell lung cancer receiving immune checkpoint therapy

Autor: Yoichi Nakanishi, Kojiro Hata, Ryosuke Matsukane, Isamu Okamoto, Ichiro Ieiri, Hiroyuki Watanabe, Kimitaka Suetsugu, Toshikazu Tsuji, Nobuaki Egashira
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
Oncology
Adult
Male
medicine.medical_specialty
Science
Cancer immunotherapy
Serum Albumin
Human
Kaplan-Meier Estimate
Article
03 medical and health sciences
Prognostic markers
0302 clinical medicine
Liver Function Tests
Internal medicine
Carcinoma
Non-Small-Cell Lung
Medicine
Humans
Progression-free survival
Lung cancer
Immune Checkpoint Inhibitors
Aged
Proportional Hazards Models
Aged
80 and over
Multidisciplinary
Performance status
medicine.diagnostic_test
business.industry
Proportional hazards model
Hazard ratio
Bilirubin
Middle Aged
medicine.disease
Prognosis
Progression-Free Survival
030104 developmental biology
Treatment Outcome
Liver
030220 oncology & carcinogenesis
Propensity score matching
Female
Liver function
business
Liver function tests
Non-small-cell lung cancer
Zdroj: Scientific Reports
Scientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
ISSN: 2045-2322
Popis: The liver is an essential organ for regulating innate and acquired immunity. We hypothesized that the pre-treatment hepatic function affects the clinical outcome of immune checkpoint inhibitors (ICIs) in non-small cell lung cancer (NSCLC). We analyzed 140 patients with NSCLC who received ICIs. We investigated the association between pre-treatment liver function, assessed using the albumin–bilirubin (ALBI) grade, and clinical outcomes in univariate, multivariate, and propensity score matching analyses. Patients were divided into four grades according to pre-treatment liver function. Eighty-eight patients had good hepatic reserve (ALBI grade 1 or 2a), whereas 52 patients had poor hepatic reserve (ALBI grade 2b or 3). In the univariate Kaplan–Meier analysis, the ALBI grade 1, 2a group had a significantly prolonged progression-free survival (PFS, 5.3 versus 2.5 months, p = 0.0019) and overall survival (OS, 19.6 vs. 6.2 months, p = 0.0002). These results were consistent, regardless of whether the analysis was performed in patients with a performance status of 0 or 1 at pre-treatment (N = 124) or in those selected using propensity score matching (N = 76). In the multivariate analysis, pre-treatment ALBI grade was an independent prognostic factor for both PFS (hazard ratio [HR] 0.57, 95% confidence interval [95% CI] 0.38–0.86, p = 0.007) and OS (HR 0.45, 95% CI 0.29–0.72, p = 0.001). Our results suggest that pre-treatment hepatic function assessed by ALBI grade could be an essential biomarker for predicting the efficacy of treatment with ICIs in NSCLC.
Databáze: OpenAIRE
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