Abstract
BackgroundThis study aimed to identify potential predictive factors for the survival of advanced non small-cell lung cancer (NSCLC) patients undergoing first-line platinum-based chemotherapy.MethodsA total of 270 advanced NSCLC patients who underwent first-line platinum-based chemotherapy from June, 2011 to June, 2015 were enrolled. A receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of the albumin-to-fibrinogen ratio (AFR) for overall survival (OS). The predictive factors for survival were evaluated by univariate and multivariate analyses via the Cox proportional hazards regression model. The OS and progression free survival (PFS) results were determined via the Kaplan–Meier method using the log-rank analysis.ResultsBased on the results of the ROC curve analysis, 8.02 was accepted as the cut-off AFR value for OS. The metastasis stage (M0 vs M1a/b, HR: 1.73, 95% CI: 1.15–2.59, P = 0.020) and AFR (≤8.02 vs > 8.02, HR: 1.80, 95% CI: 1.09–2.78, P = 0.025) were two independent risk factors for PFS by multivariate Cox regression analysis. The AFR (≤8.02 vs > 8.02, HR: 1.79, 95% CI: 1.11–2.59, P = 0.029) was a significant predictive factor for OS in advanced NSCLC patients. The PFS (P = 0.008) and OS (P = 0.003) in the high AFR group were significantly improved compared with those in the low AFR group via the Kaplan–Meier method using the log-rank analysis.ConclusionsThe AFR could be a potential effective predictive factor for the survival in advanced NSCLC patients undergoing first-line platinum-based chemotherapy.
Highlights
This study aimed to identify potential predictive factors for the survival of advanced non small-cell lung cancer (NSCLC) patients undergoing first-line platinum-based chemotherapy
albumin-to-fibrinogen ratio (AFR) and clinical characteristics Based on the results of the receiver operating characteristic (ROC) curve analysis, 8.02 was accepted as the cut-off AFR value for overall survival (OS), with an area under the curve (AUC) of 0.791, a sensitivity of 65.64% and a specificity of 77.33%, respectively (Fig. 1)
NSCLC Non–small cell lung cancer, AFR Albumin-to-fibrinogen ratio, Eastern Cooperative Oncology Group performance status (ECOG PS) Eastern cooperative oncology group performance status, TNM Tumor–node– metastasis, SCC Squamous carcinoma, AC Adenocarcinoma, DP Docetaxel combined with platinum, AP Pemetrexed combined with platinum, GP Gemcitabine combined with platinum, complete response (CR) Complete response, partial response (PR) Partial response, stable disease (SD) Stable disease, progressive disease (PD) Progressive disease, WBC White blood cell, CRP C-reactive protein
Summary
This study aimed to identify potential predictive factors for the survival of advanced non small-cell lung cancer (NSCLC) patients undergoing first-line platinum-based chemotherapy. Non small-cell lung cancer (NSCLC), the most common type of LC, compromises for nearly 85% of all LC cases [2]. Most NSCLC patients are diagnosed at a. Ying et al BMC Cancer (2019) 19:288 solid tumors, including NSCLC [7]. Targeted therapy, such as anaplastic lymphoma kinase (ALK) inhibitors and tyrosine kinase inhibitors (TKIs), has attracted much attention due to its improvements in tolerability and efficacy [8]. Other researchers have suggested that the combination treatment strategies may maximize the treatment efficacy for NSCLC [7]
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