The Predictive Significance of the Advanced Lung Cancer Inflammation Index (ALI) in Patients with Melanoma Treated with Immunotherapy as Second-Line Therapy

Figures & data

Table 1 Patient Characteristics at Baseline (n = 43)

Baseline Characteristics	n (%)
Age
Median (range)	57 (26–84)
Gender
Male	19 (44.2%)
Female	24 (55.8%)
Body mass index, kg/m^2
Median (range)	23.71 (18.29–32.27)
<18.5	1 (2.3%)
18.5–25	25 (58.1%)
>25	17 (39.6%)
Serum albumin, g/dL
Median (range)	4.15 (3.35–4.86)
Neutrophil-to-lymphocyte ratio (NLR)
Median (range)	2.33 (1.00–5.43)
Advanced lung cancer inflammation index (ALI)
Median (range)	45.69 (14.28–101.67)
C-reactive protein, mg/L
Median (range)	2.2 (0.2–93.4)
C-reactive protein-to-albumin ratio (CAR)
Median (range)	0.54 (0.047–25.31)
Lactate dehydrogenase, IU/L
Median (range)	196 (107–805)

Table 2 Patient Characteristics at Baseline Classified by the Advanced Lung Cancer Inflammation Index (n = 43)

	ALI < 50.98 (n = 24)	ALI ≥ 50.98 (n = 19)	P value
Age			0.359
Median (range)	60 (38–84)	53 (26–79)
Gender			0.388
Male	12 (50%)	7 (36.8%)
Female	12 (50%)	12 (63.2%)
Body mass index, kg/m^Citation2			0.010
Median (range)	22.17 (18.29–27.45)	26.13 (19.15–32.27)
Serum albumin, g/dL			0.261
Median (range)	3.99 (3.35–4.73)	4.17 (3.60–4.86)
Neutrophil-to-lymphocyte ratio (NLR)			< 0.001
Median (range)	3.32 (1.40–5.43)	1.50 (1.00–2.60)
Advanced lung cancer inflammation index (ALI)			< 0.001
Median (range)	27.95 (14.28–50.68)	66.85 (51.28–101.67)
C-reactive protein, mg/L			0.002
Median (range)	6.75 (0.5–93.4)	1.2 (0.2–8.7)
C-reactive protein-to-albumin ratio (CAR)			0.002
Median (range)	1.55 (0.12–25.31)	2.95 (0.047–2.31)
Lactate dehydrogenase, IU/L			0.152
Median (range)	203.5 (124–805)	173 (107–513)

Figure 1 Outcomes of receiver operating characteristic (ROC) curve analyses. ROC curve analysis for advanced lung cancer inflammation index (A), C-reactive protein-to-albumin ratio (B) and neutrophil-to-lymphocyte ratio (C).

Figure 2 Kaplan–Meier survival curves of progression-free survival. PFS analysis of all eligible patients (A) PFS analysis of high-ALI group and low-ALI group (B) PFS analysis of low CRP/ALB group and high CRP/ALB group (C) PFS analysis of low NLR group and high NLR group (D).

Table 3 Univariate Analyses and Multivariate Analyses for the Response to Immunotherapy

	Univariate Analyses		Multivariate Analyses
Baseline Characteristics	P	HR (95% CI)	P	HR (95% CI)
Gender	0.514	0.78 (0.37–1.65)	0.255	0.64 (0.30–1.38)
Age	0.114	1.82 (0.87–3.82)	0.184	1.67 (0.78–3.58)
Body mass index	0.163	0.57 (0.26–1.26)	0.827	0.90 (0.34–2.39)
Serum albumin	0.981	1.00 (0.91–1.10)	0.388	1.05 (0.94–1.16)
Neutrophil-to-lymphocyte ratio	0.117	1.29 (0.94–1.80)	0.753	0.92 (0.57–1.51)
ALI	0.028	0.41 (0.19–0.91)	0.033	0.41 (0.18–0.93)

Hamid O, Robert C, Daud A, et al. Five-year survival outcomes for patients with advanced melanoma treated with pembrolizumab in KEYNOTE-001. Ann Oncol. 2019;30(4):582–588. doi:10.1093/annonc/mdz01130715153

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