Pretreatment albumin-to-globulin ratio as a predictive marker for tyrosine kinase inhibitor in non-small cell lung cancer
Pretreatment albumin-to-globulin ratio as a predictive marker for tyrosine kinase inhibitor in non-small cell lung cancer
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DOI：
10.3233/cbm-160581
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发表时间：
2016-01-01
影响因子：
3.1
通讯作者：
Heo, Dae Seog
中科院分区：
文献类型：
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作者：
Park, Sehhoon;Park, Seongyeol;Heo, Dae Seog
背景：低白蛋白/球蛋白比率(AGR)已被认为是癌症相关死亡率的预后因素。然而，还没有研究阐明其作为靶向治疗时代的预测因素的有效性，因此，我们在本研究中对其进行了评估。方法：我们回顾分析了2012例接受表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKIs)治疗的非小细胞肺癌(NSCLC)患者。在这些患者中，包括645名具有EGFR突变和合适的治疗前实验室指标的患者。治疗前2个月和治疗后4个月计算AGR。结果：无进展生存期的最佳临界值为1.17时，无进展生存期最高可达1.89%(P&0.001)。治疗前AGR<；1.17的患者中位PFS为9.5个月(95%可信区间7.0-10.4)，治疗前AGR>；=1.17的患者中位PFS为13.5个月(95%可信区间11.9-14.7)。治疗前AGR显示出独立的预测值(调整后的HR1.8，P<；0.001)，调整了年龄、表现状态和TKI前的系统治疗。结论：我们建议EGFR突变的非小细胞肺癌患者在EGFR TKI治疗开始时AGR值低于1.17时应被认为具有早期EGFR TKI失败的高风险。
BACKGROUND: A low albumin-to-globulin ratio (AGR) has been known as a prognostic factor for cancer-related mortality. However, no study has elucidated its usefulness as a predictive factor in the era of targeted therapy, and so, we evaluated this in the present study.METHODS: We retrospectively analyzed 2012 non-small cell lung cancer (NSCLC) patients treated with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). Among these patients, 645 patients who had EGFR mutation and suitable pretreatment laboratory values were included. AGR was calculated 2 months before treatment and 4 months after treatment in each patient. The optimal cutoff value of AGR, and progression free survival (PFS) were also determined.RESULTS: The optimal cutoff value of AGR was 1.17, which yielded a highest HR of 1.89 (P < 0.001) for poor PFS. The median PFS was 9.5 months (95% confidential interval [CI] 7.0-10.4) in patients with pretreatment AGR < 1.17 and 13.5 months (95% CI 11.9-14.7) in those with pretreatment AGR >= 1.17. Pretreatment AGR showed an independent predictive value (adjusted HR 1.80, P < 0.001) when age, performance status, and pre-TKI systemic treatment was adjusted for.CONCLUSIONS: We suggest that patients with NSCLC with EGFR mutations who have AGR values lower than 1.17 at the beginning of EGFR TKI treatment should be considered to have a high risk of early EGFR TKI failure.