Advanced lung cancer inflammation index predicts survival outcomes of hepatocellular carcinoma patients receiving immunotherapy

Abstract

ObjectiveWe evaluate the predictive significance of the Advanced Lung Cancer Inflammation Index (ALI) in patients with advanced hepatocellular carcinoma (HCC) following therapy with immune checkpoint drugs.MethodsIn 2018-2020, 98 patients with advanced hepatocellular carcinoma who were treated with immune checkpoint inhibitors at our hospital were compiled. Using the receiver operating characteristic (ROC) curve, the appropriate cut-off point for ALI was determined. Kaplan-Meier analysis, the Cox proportional hazards model, and Nomogram plots highlighted the relationship between ALI and overall survival (OS). The model was validated using calibration plots, receiver operating characteristic curves (ROC), and decision curve analysis (DCA), which was performed on 52 patient sets by external validation.ResultsThe AUC for ALI was 0.663. The best cutoff value was 36.5, with a median overall survival (OS) of 473 days for patients with ALI≤ 36.5 and 611 days for those with ALI > 36.5. Univariate analysis revealed that the presence or absence of local treatment, alpha-fetoprotein (AFP), and ALI were prognostic factors; LASSO regression analysis identified four candidate variables. Multifactorial COX analysis revealed that high ALI was an independent prognostic factor for overall survival in both groups (HR = 0.411; 95% CI: 0.244-0.651; P<0.001). In addition, the Nomogram model that included ALI was able to predict the success of immunotherapy in patients with advanced liver cancer more accurately.ConclusionALI is a novel prognostic marker in immunotherapy-treated patients with advanced hepatocellular cancer.

Association of the Advanced Lung Cancer Inflammation Index (ALI) and Gustave Roussy Immune (GRIm) score with immune checkpoint inhibitor efficacy in patients with gastrointestinal and lung cancer

“…Following the removal of duplicate studies and initial screening of titles and abstracts, we proceeded to evaluate the full texts of 22 articles. Among them, 15 articles with 19 studies met the eligibility criteria, resulting in a total of 3335 patients [ 19 , 22 , 29 – 41 ]. The study selection process is presented in Fig.…”

Advanced lung cancer inflammation index predicts overall survival of hepatocellular carcinoma after hepatectomy

“…ALI before immunotherapy is a strong predictor for disease control and provides great predictive value for metastatic melanoma patients treated with immunotherapy as second-line therapy ( 25 ). In HCC, ALI was also found to predict HCC survival in patients with advanced HCC receiving immunotherapy ( 13 , 14 ). Nevertheless, the link between ALI, systemic inflammation, and treatment response remains to be elucidated.…”

“…Subsequent studies suggest that ALI can effectively predict prognosis in various types of tumors (10)(11)(12). ALI was also found to predict HCC survival in patients with advanced HCC receiving immunotherapy (13,14). However, the thorough prognostic value of the ALI for potentially curative HCC remained to be clarified.…”

Prognostic Nutritional Index Predicts Efficacy and Immune-Related Adverse Events of First-Line Chemoimmunotherapy in Patients with Extensive-Stage Small-Cell Lung Cancer

“…In addition to tumor tissue biomarkers, there has been growing interest in identifying blood-based biomarkers that can predict the efficacy of immunotherapy in solid tumors. In numerous studies, it has been suggested that NLR, 18 PLR, 19 ALI 34,35 and PNI 26 are closely associated with the prognosis of patients with cancer undergoing immunotherapy. However, our study showed that NLR did not serve as a reliable predictor of PFS in patients with SCLC receiving immunotherapy (Figure 1A), and its ability to predict OS was only moderate (Figure 2A).…”