The value of the Advanced Lung Cancer Inflammation Index (ALI) in assessing the prognosis of patients with hepatocellular carcinoma treated with camrelizumab: a retrospective cohort study

Abstract

Background: The Advanced Lung Cancer Inflammation Index (ALI) is considered a useful prognostic biomarker for clinical outcome in patients with malignancy. However, the prognostic value of ALI in patients with advanced hepatocellular carcinoma (HCC) is unclear. In this study we assessed the prognostic value of the ALI in patients with HCC treated with camrelizumab.Methods: This retrospective study analyzed patients with advanced hepatocellular carcinoma treated with the ICI, camrelizumab alone or in combination at Henan Cancer Hospital from January 2017 to January 2020. Sixty-five patients were finally screened for at least 2 years of follow-up according to the inclusion criteria, with no significant differences in patient baseline data. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off point for the ALI which was compared to other clinical indicators for predicting survival. A Kaplan-Meier analysis and Cox proportional analysis were conducted to examine the association between the ALI and patient prognosis. Results:The median overall survival (OS) for the overall group of patients was 383 days, the area under the curve for ALI was 0.815 and the optimal cut-off value for predicting OS was 34.65. The median OS for patients with an ALI score ≤34.65 was 336 days and that for patients with an ALI score >34.65 was 524 days.The univariate analysis showed that the Eastern Cooperative Oncology Group (ECOG) score, aspartate aminotransferase (AST) level, and the ALI score predicted OS. The multivariate analysis showed that the ALI score was an independent prognostic factor of OS in patients with advanced HCC who had been treated with immunotherapy [hazard ratio (HR) =0.285, 95% confidence interval (CI): 0.097-0.833, P=0.022]. A nomogram that included ALI performed well relative to the prediction of prognosis after immunotherapy for patients with advanced liver cancer. Conclusions:The ALI may be a new prognostic marker in patients with advanced HCC undergoing immunotherapy.

Routine perioperative blood tests predict survival of resectable lung cancer

“…Jafri et al, developed an advanced lung cancer inflammation index (ALI) that combined body mass index (BMI) and albumin with NLR 10 . Several studies have corroborated these findings, where low ALI scores are associated with a poor prognosis in various solid tumors (including lung cancer) 11 – 14 . Valero et al, recently proposed a novel index (Host-Index) that included parameters such as neutrophils, monocytes, hemoglobin, albumin, and lymphocytes.…”

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.…”

The advanced lung cancer inflammation index is a prognostic factor for gastrointestinal cancer patients undergoing surgery: a systematic review and meta-analysis

“…Zhang X showed that preoperative ALI was an independent prognostic factor for GC patients undergoing curative gastrectomy [29]. ALI was also revealed to be a prognostic predictor for EC, liver cancer, and cholangiocarcinoma [30][31][32][33]. However, Pian G, Yin CZ, and Barth DA reported that there was no significant difference between ALI and DFS after gastrointestinal surgery [22,28,34].…”

“…Pian G, Yin CZ, and Barth DA et al demonstrated that there was no significant difference in ALI between patients receiving CRC surgery or GC surgery [22,28,34]. Others thought that a low ALI level would lead to a poor prognosis for gastrointestinal cancer patients [21,[23][24][25][26][27][29][30][31][32][33]. Therefore, we aimed to explore the exact prognostic ability of ALI for patients with gastrointestinal cancer undergoing surgery.…”

“…Therefore, ALI could reflect the inflammation and nutrition state. Currently, some studies have reported that ALI can predict the survival of many cancers, including CRC [21][22][23][24][25][26][27], GC [28,29], EC [30,31], liver cancer [32], cholangiocarcinoma [33], pancreatic cancer [34,35], and B-cell lymphoma [36].…”