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Albumin-globulin ratio is a predictive biomarker of antitumor effect of anti-PD-1 antibody in patients with non-small cell lung cancer.

Authors
  • Nakanishi, Yu1
  • Masuda, Takeshi2
  • Yamaguchi, Kakuhiro1
  • Sakamoto, Shinjiro1
  • Horimasu, Yasushi1
  • Mimae, Takahiro3
  • Nakashima, Taku1
  • Miyamoto, Shintaro1
  • Tsutani, Yasuhiro3
  • Iwamoto, Hiroshi1
  • Fujitaka, Kazunori1
  • Miyata, Yoshihiro3
  • Hamada, Hironobu1
  • Okada, Morihito3
  • Hattori, Noboru1
  • 1 Department of Respiratory Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. , (Japan)
  • 2 Department of Respiratory Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. [email protected] , (Japan)
  • 3 Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. , (Japan)
Type
Published Article
Journal
International journal of clinical oncology
Publication Date
Jan 01, 2020
Volume
25
Issue
1
Pages
74–81
Identifiers
DOI: 10.1007/s10147-019-01539-2
PMID: 31531785
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Anti-programmed cell death receptor (PD)-1 antibody treatment results in better prognosis than standard chemotherapy in patients with non-small cell lung cancer (NSCLC), especially those with high PD-ligand 1 (PD-L1) expression. However, several studies have reported a lack of antitumor effect of PD-1 antibody, even in patients with high PD-L1 expression. Therefore, reliable predictors of treatment response are urgently needed. The albumin-globulin ratio (AGR) is associated with prognosis in several cancers. We aimed to determine whether AGR is a predictive biomarker of anti-PD-1 antibody response in patients with NSCLC. Seventy-four NSCLC patients treated with anti-PD-1 antibody were retrospectively enrolled. Patients with driver mutations were excluded. The mean AGR was significantly higher in the disease control (DC) group than in the progressive disease (PD) group (p < 0.001). Receiver operating characteristic curve analysis revealed an AGR cutoff value for dividing patients into the DC or PD groups of 1.17. Multivariate logistic regression analysis showed that a high AGR (≥1.17, cutoff value) was an independent predictor of DC (p = 0.001). Progression-free survival (PFS) and overall survival (OS) were significantly longer in the high-AGR group than in the low-AGR group (p = 0.008, p = 0.002, respectively). Multivariate Cox regression analysis of PFS and OS showed that high AGR was an independent prognostic factor (p = 0.020, p < 0.001, respectively). Pretreatment serum AGR may be a useful predictor for DC and prognostic factor of anti-PD-1 antibody in patients with NSCLC. The clinical utility of AGR still needs to be confirmed in a prospective analysis.

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