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

Abstract

BACKGROUND:

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.

PATIENTS AND METHODS:

Seventy-four NSCLC patients treated with anti-PD-1 antibody were retrospectively enrolled. Patients with driver mutations were excluded.

RESULTS:

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).

CONCLUSION:

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.

• Authors: Yu Nakanishi, Takeshi Masuda, Kakuhiro Yamaguchi, Shinjiro Sakamoto, Yasushi Horimasu, Takahiro Mimae, Taku Nakashima, Shintaro Miyamoto, Yasuhiro Tsutani, Hiroshi Iwamoto, Kazunori Fujitaka, Yoshihiro Miyata, Hironobu Hamada, Morihito Okada, Noboru Hattori
• Journal: International journal of clinical oncology (Int J Clin Oncol) Vol. 25 Issue 1 Pg. 74-81 (Jan 2020) ISSN: 1437-7772 [Electronic] Japan
• PMID: 31531785 (Publication Type: Journal Article)

Chemical References

• Antineoplastic Agents, Immunological
• Biomarkers, Tumor
• Programmed Cell Death 1 Receptor
• Serum Albumin
• Serum Globulins

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents, Immunological (therapeutic use)
• Biomarkers, Tumor (blood)
• Carcinoma, Non-Small-Cell Lung (blood, drug therapy, metabolism, pathology)
• Female
• Humans
• Lung Neoplasms (blood, drug therapy, metabolism, pathology)
• Male
• Middle Aged
• Prognosis
• Programmed Cell Death 1 Receptor (agonists)
• Retrospective Studies
• Serum Albumin (analysis)
• Serum Globulins (analysis)
• Survival Analysis