ABSTRACT
INTRODUCTION: The albumin-bilirubin (ALBI) grade is a novel indicator of the liver function. Some studies showed that the ALBI grade was a prognostic and predictive biomarker for the efficacy of chemotherapy in cancer patients. The association between the ALBI grade and outcomes in patients with non-small-cell lung cancer (NSCLC) treated with cancer immunotherapy, however, is poorly understood. METHODS: We retrospectively enrolled 452 patients with advanced or recurrent NSCLC who received anti-programmed cell death protein 1 (PD-1)-based therapy between 2016 and 2019 at three medical centers in Japan. The ALBI score was calculated from albumin and bilirubin measured at the time of treatment initiation and was stratified into three categories, ALBI grade 1-3, with reference to previous reports. We examined the clinical impact of the ALBI grade on the outcomes of NSCLC patients receiving anti-PD-1-based therapy using Kaplan-Meier survival curve analysis with log-rank test and Cox proportional hazards regression analysis. RESULTS: The classifications of the 452 patients were as follows: grade 1, n = 158 (35.0%); grade 2, n = 271 (60.0%); and grade 3, n = 23 (5.0%). Kaplan-Meier survival curve analysis showed that the ALBI grade was significantly associated with progression-free survival and overall survival. Moreover, Cox regression analysis revealed that the ALBI grade was an independent prognostic factor for progression-free survival and overall survival. CONCLUSION: The ALBI grade was an independent prognostic factor for survival in patients with advanced or recurrent NSCLC who receive anti-PD-1-based therapy. These findings should be validated in a prospective study with a larger sample size.
Subject(s)
Albumins , Bilirubin , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Albumins/analysis , Bilirubin/analysis , Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/drug therapy , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/drug therapy , Neoplasm Recurrence, Local , Prognosis , Programmed Cell Death 1 Receptor/antagonists & inhibitors , Prospective Studies , Retrospective StudiesSubject(s)
Adrenal Insufficiency/chemically induced , Antibodies, Monoclonal/adverse effects , Antineoplastic Agents, Immunological/adverse effects , Substance Withdrawal Syndrome/etiology , Adenocarcinoma/drug therapy , Adenocarcinoma/immunology , Adenocarcinoma/surgery , Adenocarcinoma of Lung , Adrenal Insufficiency/immunology , Aged , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal/immunology , Antineoplastic Agents, Immunological/administration & dosage , Antineoplastic Agents, Immunological/immunology , Clinical Trials, Phase III as Topic , Female , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/immunology , Lung Neoplasms/surgery , Male , Nivolumab , Randomized Controlled Trials as Topic , Substance Withdrawal Syndrome/immunologyABSTRACT
A 56-year-old women was admitted for examination of glycosuria. She had had a blunt trauma onto the left abdomen 2 years ago that could have caused renal injury. Incidentally a left renal mass was detected by ultrasonography as a low echogenic mass. CT scan revealed a 2.5 X 2.5 cm mass with lower density than the kidney. IVP and renal angiography showed no abnormal findings. Under the diagnosis of renal tumor, left nephrectomy was performed. A 2 X 2 cm butter-yellow tumor, was seen in the renal parenchyma including the renal capsule of the upper and lateral part of the kidney. The renal pelvis was normal and there were no suppurative lesions in the kidney. Histopathological diagnosis was xanthogranuloma of the kidney partly containing a subcapsular hematoma. The previous blunt trauma, presence of hematoma and no evidence of suppurative lesions suggested that the etiology of xanthogranuloma in this case was related to renal injury.
