1. A Novel Prognostic Indicator for Immunotherapy Response: Lymphocyte-to-Albumin (LA) Ratio Predicts Survival in Metastatic NSCLC Patients.
- Author
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Yildirim, Sedat, Dogan, Akif, Akdag, Goncagul, Cavdar, Eyyup, Kinikoglu, Oguzcan, Oksuz, Sila, Yildiz, Hacer Sahika, Kucukoz Uzun, Aysun, Isik, Deniz, Surmeli, Heves, Basoglu, Tugba, Sever, Ozlem Nuray, Odabas, Hatice, Yildirim, Mahmut Emre, and Turan, Nedim
- Subjects
RECEIVER operating characteristic curves ,STATISTICAL significance ,IMMUNOTHERAPY ,LYMPHOCYTE count ,RETROSPECTIVE studies ,MULTIVARIATE analysis ,DESCRIPTIVE statistics ,METASTASIS ,IMMUNE checkpoint inhibitors ,KAPLAN-Meier estimator ,MEDICAL records ,ACQUISITION of data ,LUNG cancer ,ALBUMINS ,SURVIVAL analysis (Biometry) ,PROGRESSION-free survival ,CONFIDENCE intervals ,DATA analysis software ,OVERALL survival ,PROPORTIONAL hazards models - Abstract
Simple Summary: Based on this study, we define a new biomarker termed lymphocyte-to-albumin ratio (LAR) that may predict the prognosis for patients with metastatic NSCLC treated with immunotherapy. This study aims to determine the relationship of the LA index with patients' survival rate through studying the records of 227 patients who were treated with nivolumab after one or multiple cycles of chemotherapy. Therefore, the results showed that a higher LA index is significantly related to better overall survival (OS) and progression-free survival (PFS). Overall, the LA index deserves its merit of being a simple, cost-effective, noninvasive method applicable in NSCLC immunotherapy as a clinically practical tool for predicting treatment outcomes. Objective: Immunotherapies are commonly employed for the treatment of non-small-cell lung cancer (NSCLC). However, predictive biomarkers still need to be improved to predict responses to these agents. The lymphocyte–albumin (LA) laboratory index has not been evaluated before in this patient group. The aim of this study was to analyze the relation between the LA index and the survival rate of metastatic NSCLC patients who had immunotherapy after at least one round of chemotherapy. Methods: The research included 227 patients diagnosed with metastatic NSCLC, who were administered nivolumab after at least one round of chemotherapy. The LA index was calculated by multiplying lymphocyte count and albumin concentration. The optimal threshold values for the index were established by the examination of the ROC curve for both overall survival (OS) and progression-free survival (PFS). Oncological data were obtained retrospectively from patient files, and survival analyses were performed. Results: The median follow-up was 7.9 months. Progression was observed in 129 (56.9%) patients. A total of 97 (42.7%) patients died during the follow-up. The cutoff values of the LA index to predict OS and PFS were determined as 52.87 and 57.67, respectively. The low-LA group had significantly lowered OS and PFS compared to the high-LA group. LA was found to be an independent prognostic factor for PFS (hazard ratio 4.47; 95% confidence interval, 2.73–7.34; p < 0.001) and OS (hazard ratio 6.24; 95% confidence interval, 3.46–11.25; p < 0.001) in the multivariate regression analysis. Conclusions: In this study, we observed that the LA index independently predicts OS and PFS in immunotherapy-treated metastatic NSCLC patients. Its ease of application, low cost, and noninvasive nature make it a potential guide for clinicians in predicting treatment responses and survival. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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