Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers worldwide, with a 5-y survival rate of 9%. 1 Genomic analyses of PDAC revealed that 4 common driver genes (KRAS, TP53, CDKN2A, and SMAD4), called the "big 4," are mutated with high frequencies, and many other genes are altered at lower frequencies, including potential clinical targets. Activating mutations in KRAS that occur early in tumorigenesis are observed frequently, and tend to be

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Background/Aim: Albumin-bilirubin (ALBI) grade is an indicator of liver dysfunction and is useful for predicting postoperative prognosis of hepatocellular carcinomas. However, the significance of ALBI grade in non-small cell lung carcinoma (NSCLC) has not been elucidated. Patients and Methods: We analyzed 947 patients with pStage IA-IIIA NSCLC. We divided patients into ALBI grade 1 and grade 2/3 groups. We then analyzed the association of ABLI grade with clinicopathological characteristics and prognosis in NSCLC by using propensity-score matching. Results: ALBI grade 2/3 was significantly associated with older age, male sex, advanced pT status, and histological type. Even after propensity-score matching, ALBI grade 2/3 patients had significantly worse cancer-specific survival (CSS) than ALBI grade 1 patients (5year CSS: 87.3% versus 92.8%; p=0.0247). In multivariate analysis, ALBI grade 2/3 was an independent predictor of CSS (HR=1.9; p=0.0177). Conclusion: ALBI grade was an independent prognostic factor in surgically resected NSCLC.Non-small cell lung carcinoma (NSCLC) is one of the most lethal neoplasms worldwide (1). Studies to elucidate prognostic factors of surgically resected NSCLC have been conducted to determine appropriate postoperative follow-up and whether adjuvant chemotherapy is required.Albumin-bilirubin (ALBI) grade was first described by Johnson et al. in 2015 as an indicator of liver dysfunction in patients with hepatocellular carcinoma (2). ALBI grade, which is determined using only serum levels of albumin and totalbilirubin, has attracted much attention as a more convenient marker compared with conventional indexes of liver dysfunction such as Child-Pugh score and liver damage grade (2-5). In hepatocellular carcinoma, several studies have demonstrated that ALBI grade is useful for predicting the response to radiofrequency ablation (6), transarterial chemoembolization (7, 8), and molecular targeted therapy (8-10), as well as postoperative prognosis (2,5,6,8,(11)(12)(13). Furthermore, the prognostic value of ALBI grade has also been described in intrahepatic cholangiocarcinomas (14), pancreatic cancer (15), and gastric cancer (16). However, the significance of ALBI grade in NSCLC has not been elucidated.The association of liver function with NSCLC was evaluated in a study that analyzed surgical outcomes of NSCLC with liver cirrhosis and demonstrated that the postoperative mortality of patients with Child-Pugh score B was higher than that of patients with Child-Pugh score A (17). Therefore, liver function may be an important factor in the prognosis of NSCLC. In the present study, we aimed to elucidate the prognostic impact of ALBI grade in surgically resected NSCLC patients. Patients and MethodsPatients. This study was approved by our institutional review board (Kyushu University, Kyushu, Japan, IRB No. 2019-232). One thousand seventeen patients with surgically resected pathological

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Background/Aim: Programmed death-ligand 1 (PD-L1/CD274) elicits T-cell anergy, leading to immune suppression. We aimed to determine the prognostic relevance of PD-L1 expression in the blood of breast cancer (BC) patients. Materials and Methods: We measured PD-L1 mRNA expression in blood and tumor tissues of BC patients using RT-qPCR and a dataset from The Cancer Genome Atlas, and performed a survival analysis of PD-L1 expression in the blood of 330 BC patients. Flow cytometric analysis was performed using blood cells. Results: No statistical difference in PD-L1 expression was seen between normal controls and BC in blood or tissues. There was a significant positive correlation between the PD-L1 expression levels in blood and tissues. Decreased PD-L1 expression in blood or tissues was associated with poor recurrence-free survival. PD-L1 is mainly expressed in polymorphonuclear leukocytes. Conclusion: Low expression of PD-L1 in the blood could serve as a biomarker of poor prognosis in BC patients.The immune system plays an essential role in the surveillance and eradication of neoplastic cells. In fact, cancer immunotherapy has become the fourth pillar of cancer treatment, complementing surgery, chemotherapy and radiotherapy (1). In cancer immunotherapy, development of immune checkpoint inhibitors (ICI), which block the immunosuppressive effects of tumors on T cells, have become considerably important in the clinic (2, 3).Programmed death-ligand 1 (PD-L1/CD274) is a transmembrane protein that binds to the inhibitory receptor PD-1 (PDCD1) on T cells where it elicits T-cell anergy, leading to immune suppression (4). Many cancer cells upregulate PD-L1 surface expression to escape immunosurveillance (5, 6). ICI, including neutralizing antibodies targeting PD-L1 or PD-1, can block T-cell anergy and thereby resensitize tumor cells to antitumor immunity (6). This approach has shown significant therapeutic promise in the treatment of various cancers (7, 8), such as PD-L1positive metastatic triple-negative breast cancer (TNBC) combined with anti-cancer drug nab-paclitaxel (9-12).Among multiple cancer types, positive responses to PD-1/PD-L1-targeted therapy have been observed in patients with high PD-L1 expression on tumors cells, as revealed by immunohistochemical staining (tumor proportion score ≥1%) (13). However, these biomarkers require invasive sampling and are not practical from a risk-benefit standpoint for monitoring tumor responsiveness during treatment. Furthermore, many studies investigating the prognostic implications of PD-L1 expression in tumor tissues of breast cancer (BC) patients have reported conflicting results, probably because of tumor heterogeneity (14).There is growing interest in the use of "liquid biopsies" to identify biomarkers in body fluids, mainly in the blood (15). Circulating liquid biopsy biomarkers have recently shown promise as a metric for the prediction of tumor immunotherapy responses. This approach is less invasive and more cost-effective in providing "real-time" information regarding no...