Pretreatment Albumin To Globulin Ratio Research Articles

Neutrophil to lymphocyte ratio and principal component analysis offer prognostic advantage for dogs with mammary tumors.

In veterinary medicine, cancer is the leading cause of death in companion animals, and mammary gland tumors represent the most common neoplasm in female dogs. Several epidemiological risk factors, such as age, breed, hormones, diet, and obesity have been reported to be relevant for canine mammary tumors. Nowadays, the gold standard for diagnosis of canine mammary tumors is the pathological examination of the suspected tissue. However, tumor grade can only be assessed after surgical removal or biopsy of the altered tissue. Therefore, in cases of tumors that could be surgically removed, it would be very helpful to be able to predict the biological behavior of the tumor, before performing any surgery. Since, inflammation constitutes part of the tumor microenvironment and it influences each step of tumorigenesis, cellular and biochemical blood markers of systemic inflammation, such as the neutrophil to lymphocyte ratio (NLR) and the albumin to globulin ratio (AGR) have been proposed as prognostic factors for human cancer development. The NLR and the AGR have not been explored enough as prognostic factors for cancer development in veterinary medicine. To determine the prognostic value of NLR in canine mammary tumors, clinical records including biochemistry and hematological studies of female dogs with mammary tumors and of control healthy dogs, were used to determine the pre-treatment NLR and AGR. Other clinical data included age, breed, tumor size, histological tumor grade, and survival time after surgery. It was found that a higher pre-treatment NLR value (NLR > 5) associates with less survival rate. In contrast, the AGR did not show any predictive value on the malignancy of the tumor. However, by combining the NLR with AGR, age of the dog, and tumor size in a principal component analysis (PCA), the grade of the tumor and survival after surgery could be appropriately predicted. These data strongly suggest that pre-treatment NLR values have a prognostic value for the survival rate after surgery of dogs with mammary tumors.

Low Pretreatment Albumin-to-Globulin Ratios Predict Poor Survival Outcomes in Patients with Head and Neck Cancer: A Systematic Review and Meta-analysis.

Background: Studies have indicated that a low albumin-to-globulin ratio (AGR) before treatment is linked to poor prognosis of many cancers, but the prognostic impact of AGR remains controversial in head and neck cancer (HNC). This meta-analysis examined the prognostic value of AGR in HNC. Methods: We systematically searched the Embase, PubMed, and Cochrane library for relevant articles from inception to July 22, 2022. Studies conducted from 2000 to 2022 exploring the prognostic value of AGR in HNC were retrieved. We employed a random-effects model and calculated pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) to examine the associations of AGR with survival outcome. Results: Our analysis included nine studies involving 3211 patients with HNC. The pooled results revealed significant associations between low pretreatment AGRs and poor disease-free survival (HR = 1.97, 95% CI 1.58-2.45, p < 0.001), distant metastasis-free survival (HR = 1.64, 95% CI 1.25-2.16, p < 0.001), overall survival (HR = 2.18, 95% CI 1.65-2.88, p < 0.001), T3-T4 status (OR = 2.22, 95% CI 1.43-3.44, p < 0.001), stage III-IV disease (OR = 2.62, 95% CI 1.62-4.23, p < 0.001), and lymph node metastasis (OR = 1.95, 95% CI 1.29-2.82, p = 0.001) in patients with HNC. Conclusion: AGR can serve as a prognostic biomarker in managing HNC, and a low pretreatment AGR is strongly associated with adverse survival outcomes and advanced cancer status. Additional large-scale prospective trials must be conducted to assess the validity of our findings.

Serum albumin to globulin ratio prior to treatment as a potential non-invasive prognostic indicator for urological cancers

Numerous clinical studies have reported an association between the pretreatment albumin to globulin ratio (AGR) and survival outcomes of urological cancers. However, these conclusions remain controversial. Therefore, we performed a meta-analysis to explore the prognostic value of the AGR in urinary system tumors. We retrieved eligible studies published up to June 2022 through a comprehensive search of multiple databases. Pooled hazard ratios (HRs) with 95% confidence intervals (CI) for overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), progression-free survival (PFS), and biochemical recurrence-free survival (BRFS) were used to evaluated the predictive effect of the AGR before treatment in urinary system tumors. Heterogeneity test, random-effects models, fixed-effects models and sensitivity tests were used for analyses. A total of 21 studies with 18,269 patients were enrolled in our meta-analysis. We found that patients with urinary system cancer with low AGR prior to treatment had poor OS [HR = 1.93, 95% CI (1.56-2.39), p < 0.001], CSS [HR = 2.22, 95% CI (1.67-2.96), p < 0.001], RFS [HR = 1.69, 95% CI (1.29-2.22), p < 0.001], and PFS [HR = 1.29, 95% CI (0.54-3.07), p < 0.001]. For prostate cancer (PCa), a low pretreatment AGR was associated with poor BRFS [HR = 1.46, 95% CI (1.28-1.67), p < 0.001]. Also, a subgroup analysis, stratified by ethnicity, cancer type, cutoff value, sample size and publication year, was conducted. The results showed that worse OS and CSS were significantly associated with these factors. Our meta-analysis revealed that the AGR before treatment could be used as a non-invasive predictive biomarker to evaluate the prognosis of urological cancer patients in clinical practice.

Clinical impact of pretreatment albumin-globulin ratio in patients with colorectal cancer: A meta-analysis.

Background:Accumulating evidence have revealed that pretreatment albumin to globulin ratio (AGR) may be a predictor of prognosis among patients with colorectal cancer (CRC). However, these findings are inconsistent. The aim of the present study was to investigate the prognostic value of pretreatment AGR in CRC.Methods:A systematic meta-analysis was conducted by searching MEDLINE, EMBASE, and Cochrane Library databases.Results:A total of 9 studies with 7939 patients were finally included. Low pretreatment AGR was associated with worse overall survival (pooled hazard ratio [HR]: 2.07, 95% CI: 1.60–2.67, P < .001) and disease-free survival/progress-free survival (pooled hazard ratio [HR]: 2.10, 95% confidence interval [CI]: 1.34–3.31, P = .001). Subgroup analyses revealed that the pooled correlation did not alter these results. Moreover, low pretreatment AGR were associated with elderly patients, tumor diameter (≥50 mm), tumor node metastasis stage (III–IV), depth of tumor (T3–4), and CA19-9 (>37 U/mL).Conclusion:The present meta-analysis suggests that low pretreatment AGR was associated with advanced clinicopathological features and worse prognosis, suggesting AGR is a useful prognostic biomarker for CRC patients.

Prognostic significance of the albumin-to-globulin ratio for advanced urothelial carcinoma treated with pembrolizumab: a multicenter retrospective study

Although the albumin-to-globulin ratio (AGR) is a promising biomarker, no study has investigated its prognostic significance for advanced urothelial carcinoma (UC). This study conformed to the REporting recommendations for tumor MARKer prognostic studies (REMARK) criteria. We retrospectively reviewed 176 patients with advanced UC treated with pembrolizumab between 2018 and 2020. We evaluated the associations between pretreatment clinicopathological variables, including the AGR and performance status (PS), with progression-free survival, cancer-specific survival, and overall survival. The Cox proportional hazards model was used for univariate and multivariable analyses. The AGR was dichotomized as < 0.95 and ≥ 0.95 based on receiver operating characteristic curve analysis. After excluding 26 cases with missing data from the total of 176 cases, 109 (73%) patients experienced disease progression, 75 (50%) died from UC, and 6 (4%) died of other causes (median survival = 12 months). Multivariate analyses identified PS ≥ 2 and pretreatment AGR < 0.95 as independent poor prognostic factors for all endpoints. Furthermore, a prognostic risk model incorporating these two variables achieved a relatively high concordance index for all endpoints. This is the first report to evaluate the significance of AGR in advanced UC. Pretreatment AGR < 0.95 may serve as a prognostic marker for advanced UC treated with pembrolizumab.

Decrease of Preoperative Serum Albumin-to-Globulin Ratio as a Prognostic Indicator after Radical Cystectomy in Patients with Urothelial Bladder Cancer.

This study aims to evaluate whether preoperative serum albumin-to-globulin ratio (AGR) could predict the prognosis of patients with urothelial bladder cancer (UBC) after radical cystectomy (RC). A total of 176 patients with UBC who underwent RC in a tertiary hospital between 2008 and 2019 were retrospectively analyzed. The AGR was calculated as albumin/(total protein - albumin). In addition, the AGR was divided into two groups for the time-dependent receiver operating characteristic curve (ROC) analysis. Survival was estimated using the Kaplan-Meier analysis and compared using the log-rank test. Cox proportional- hazards models were used for multivariate survival analysis. The best cutoff AGR value for metastasis prediction was 1.32 based on the ROC curve analysis. Patients who had lower pretreatment AGR (<1.32) values composed the low-AGR group (n = 57; 32.4%). On the other hand, the remaining patients (n = 119; 67.6%) composed the high-AGR group. The patients in the low-AGR group had more advanced stage tumors compared with the patients in the high-AGR group. The Kaplan-Meier curves revealed that the patients in the low-AGR group had significantly lower rates of metastasis-free survival (MFS) and cancer-specific survival (CSS). The multivariate Cox regression analysis showed that preoperative AGR was an independent prognostic factor for MFS and CSS. In this single-institution retrospective study, lower preoperative AGR values demonstrated a poor prognostic effect on MFS and CSS in patients with UBC who underwent RC.

The prognostic value of the pretreatment serum albumin to globulin ratio for predicting adverse pathology in patients undergoing radical prostatectomy for prostate cancer.

PurposeFew studies have demonstrated the clinical significance of pretreatment serum albumin and globulin in prostate cancer (PCa). This study evaluated the association between the pretreatment albumin to globulin ratio (AGR) and clinicopathologic characteristics of nonmetastatic PCa in a large multicenter setting in Korea.Materials and MethodsThis study involved 742 patients with nonmetastatic PCa who underwent radical prostatectomy (RP) in seven institutions between January 2011 and December 2012. The AGR was calculated as follows: albumin/(total protein−albumin). Patients were divided into low and high AGR groups by a cutoff value from a receiver operating characteristic curve analysis.ResultsThe best cutoff for the AGR was set at 1.53. The area under the curve of the AGR was 0.624 (95% confidence interval, 0.557–0.671; p<0.001). Patients who had a lower pretreatment AGR (<1.53) were identified as the low AGR group (n=398, 53.6%) and the remaining patients as the high AGR group (n=344, 46.4%). Preoperative AGR was significantly lower in patients with non-organ-confined disease (≥pT3) than in those with organ-confined disease (≤pT2) (p<0.001). The low AGR group had higher aggressive pathologic Gleason scores (pGS) (≥8) than did the high AGR group (p=0.016). Furthermore, the AGR was an independent prognostic factor for high pGS (≥8) and non-organ-confined disease (≥pT3), according to multivariate logistic regression analysis.ConclusionsA low AGR was closely associated with nonconfined disease (≥pT3) and high pGS (≥8). AGR can be a useful serological marker for predicting adverse pathology in patients with nonmetastatic PCa who undergo RP.

Pre-therapy serum albumin-to-globulin ratio in patients treated with neoadjuvant chemotherapy and radical nephroureterectomy for upper tract urothelial carcinoma

PurposeThe accurate selection of patients who are most likely to benefit from neoadjuvant chemotherapy is an important challenge in oncology. Serum AGR has been found to be associated with oncological outcomes in various malignancies. We assessed the association of pre-therapy serum albumin-to-globulin ratio (AGR) with pathologic response and oncological outcomes in patients treated with neoadjuvant platin-based chemotherapy followed by radical nephroureterectomy (RNU) for clinically non-metastatic UTUC.MethodsWe retrospectively included all clinically non-metastatic patients from a multicentric database who had neoadjuvant platin-based chemotherapy and RNU for UTUC. After assessing the pretreatment AGR cut‐off value, we found 1.42 to have the maximum Youden index value. The overall population was therefore divided into two AGR groups using this cut‐off (low, < 1.42 vs high, ≥ 1.42). A logistic regression was performed to measure the association with pathologic response after NAC. Univariable and multivariable Cox regression analyses tested the association of AGR with OS and RFS.ResultsOf 172 patients, 58 (34%) patients had an AGR < 1.42. Median follow-up was 26 (IQR 11–56) months. In logistic regression, low AGR was not associated with pathologic response. On univariable analyses, pre-therapy serum AGR was neither associated with OS HR 1.15 (95% CI 0.77–1.74; p = 0.47) nor RFS HR 1.48 (95% CI 0.98–1.22; p = 0.06). These results remained true regardless of the response to NAC.ConclusionPre-therapy low serum AGR before NAC followed by RNU for clinically high-risk UTUC was not associated with pathological response or long-term oncological outcomes. Biomarkers that can complement clinical factors in UTUC are needed as clinical staging and risk stratification are still suboptimal leading to both over and under treatment despite the availability of effective therapies.

Prognostic Value of Pretreatment Albumin to Globulin Ratio in Lung Cancer: A Meta-Analysis

Objective: To explore the predictive role of pretreatment albumin to globulin ratio (AGR) for prognosis in lung cancer.Methods: A comprehensive literature retrieval was performed in the PubMed, Cochrane Library, Web of Science and EMBASE databases up to May 20, 2019. The pooled hazard ratio (HR) and 95% confidence interval (CI) were applied to assess the correlation of pretreatment AGR with overall survival (OS) and disease-free survival (DFS). Sensitivity analysis was performed to assess the stability of results. Bess’s funnel plot and Egger’s test were conducted to detect potential publication bias.Results: Eight articles involving 3496 patients were included in our meta-analysis and all studies were from Asian countries. The results demonstrated that a low pretreatment AGR was significantly associated with poor OS (HR = 1.88, 95% CI: 1.49–2.38, P<0.001) and DFS (HR = 2.09, 95% CI: 1.56–2.81, P<0.001) and sensitivity analysis indicated the stability of above results. Publication bias test showed that there were two potentially unpublished articles, but they did not have a significant influence on the results of our meta-analysis.Conclusion: Our study manifested that pretreatment AGR was a reliable predictor for survival and it may contribute to the risk evaluation and therapy strategy formulation of lung cancer patients.

Predicting the Prognosis of Gastric Cancer by Albumin/Globulin Ratio and the Prognostic Nutritional Index

Background: Albumin-to-globulin ratio (AGR) and the prognostic nutrition index (PNI) are used to assess the nutritional status and severity of disease for a cancer patient. However, the clinical significance of combining these two predictors in gastric cancer (GC) remains unclear. This study evaluated the prognostic value of pretreatment serum AGR and the PNI for GC.Methods: A total of 273 patients with GC, diagnosed between January 2010 and January 2014, were enrolled. The association of AGR, PNI with clinicopathological characters and prognosis were assessed by Cox regression and Kaplan–Meier methods.Results: Both low AGR group and low PNI group had poor overall survival (OS) and progression-free survival (PFS) (all p < 0.001), while patients with low AGR and PNI had the lowest OS rate. Multivariate analyses revealed that AGR (for OS HR = 0.657, 95%CI: 0.449–0.962, p = 0.031; for PFS HR = 0.684, 95%CI: 0.528–0.895, p = 0.035) was an independent prognostic factor for OS and PFS in patients with GC, and PNI was verified as a predictor for OS (HR = 0.782, 95%CI: 0.503 –0.997, p = 0.048).Conclusions: Low level of pretreatment AGR and PNI may be independent prognostic factors for patients with GC, and patients with both factors indicated the worst OS.

Combination of the preoperative albumin to globulin ratio and neutrophil to lymphocyte ratio as a novel prognostic factor in patients with triple negative breast cancer.

Background: The pretreatment albumin to globulin ratio (AGR) and neutrophil to lymphocyte ratio (NLR) were the inflammation-associated factors which were related to the disease-free survival in various malignancies. The aim of this study was to evaluate the clinical significance of the pretreatment AGR combined with NLR for patients with triple negative breast cancer (TNBC).Method: This retrospective study included 286 cases of pathologically diagnosed patients with TNBC. The relationships of AGR and NLR with clinicopathologic characteristics and prognosis were analyzed by Kaplan–Meier and Cox regression methods.Results: An AGR of 1.63 and a NLR of 2.93 were identified as the optimal cut-off points for distinguishing patients with good versus poor prognosis. The area under the receiver operating characteristic curves of combined with AGR and NLR (CO-AN) was increased compared with AGR and NLR individually. Kaplan–Meier analysis showed that low AGR/high NLR was related to poor survival. The prognosis of patients can be predicted well by the CO-AN. Univariate and multivariate analyses revealed that high AGR levels, low NLR levels, and CO-AN<1 were significantly and independently associated with favorable disease-free survival.Conclusions: Our study suggested that AGR and NLR levels can be prognostic biomarkers for disease-free survival in patients with TNBC. The CO-AN may have greater predictive value than AGR and NLR in patients with TNBC.

Prognostic Values of Systemic Inflammation Response (SIR) Parameters in Resectable Cervical Cancer.

Background:Cervical carcinoma is the leading cause of cancer mortality in women. C-reactive protein (CRP), albumin (ALB), globulin (GLB), lactate dehydrogenase (LDH), and albumin-to-globulin ratio (AGR) are indicators of systemic inflammation response correlated with tumor outcomes.Methods:This study recruited 110 patients with cervical cancer. The patients were divided into 2 groups according to pretreatment median values of CRP, ALB, GLB, LDH, and AGR. The post/preradiotherapy or post/pretreatment ratios were defined as rates of pretreatment CRP, ALB, GLB, LDH, and AGR values and the corresponding ones obtained after radiotherapy or whole treatment.Results:Higher pretreatment CRP or LDH levels were correlated with worse progression-free survival (PFS) and overall survival (OS). Increased post/preradiotherapy CRP ratio was correlated with worse PFS and OS, increased post/preradiotherapy LDH ratio was correlated with worse PFS. Increased post/pretreatment CRP ratio was correlated with worse PFS and OS, not-increased post/pretreatment AGR ratio was correlated with worse OS. Cox regression analysis model indicated that, moderately or poorly of differentiation, higher pretreatment CRP or LDH levels were independently associated with worse PFS, higher pretreatment CRP or LDH levels and increased post/pretreatment CRP ratio were independently associated with worse OS.Conclusion:CRP, LDH, or AGR are correlated with outcomes of resectable cervical cancer.

Prognostic Value of Pretreatment Albumin-to-Globulin Ratio in Patients With Non-Muscle-Invasive Bladder Cancer.

To investigate the relationship between albumin-to-globulin ratio (AGR) and oncologic outcomes in patients with non-muscle-invasive bladder cancer (NMIBC). We identified 364 patients with primary NMIBC who underwent transurethral surgery between 2000 and 2015. The association between pretreatment AGR and clinicopathologic variables, including oncologic outcomes, was statistically evaluated. One hundred twenty patients (33.0%) experienced at least one tumor recurrence, and 23 (6.3%) developed muscle-invasive disease. The median (interquartile range) pretreatment AGR was 1.73 (1.53-1.89). The Kaplan-Meier curve revealed that tumor recurrence was strongly predicted in patients with pretreatment AGR< 1.6, and similar results were observed for disease progression (P< .01 and P< .01, respectively). On multivariate analysis, we found that pretreatment AGR< 1.6 is an independent risk factor for tumor recurrence (hazard ratio, 0.53; P< .01). On univariate analysis, pretreatment AGR< 1.6 was also associated with disease progression (hazard ratio, 0.24; P< .01). Low pretreatment AGR is an independent risk factor for tumor recurrence and is one risk factor for disease progression in NMIBC patients. This inexpensive and easily accessible biomarker may become useful in selecting patients with NMIBC with higher risk of recurrence and progression.

Prognostic Effect of Albumin-to-Globulin Ratio in Patients with solid tumors: A Systematic Review and Meta-analysis.

Background: Albumin and globulin are main components of serum protein. The level of albumin and globulin partially represents the nutrition status and immune system. Albumin-to-globulin ratio (AGR) has been reported as a prognostic factor in various cancers. We therefore performed a meta-analysis to elucidate the prognosis effect of AGR on survival outcomes in solid tumors.Method: Six electronic database were searched for the relevant articles that assessing the prognostic value of pre-treatment AGR in solid tumor patients. The primary outcome was overall survival (OS) and the secondary outcomes were cancer-specific survival (CSS), disease-free survival (DFS) and disease-metastasis-free survival (DMFS). The time-to-event outcomes were summarized in hazard ratio (HR) and 95% confidence interval (CI).Result: A total of 13890 solid tumor patients in 24 studies were included. The AGR higher than the cut-off values ranging from 1.15-1.75 was related to better OS (HR=0.58, 95%CI 0.537-0.626, p<0.0001), CSS (HR=0.287, 95%CI 0.187-0.438, p<0.0001), DFS (HR=0.792, 95%CI 0.715-0.878, p<0.0001) and DMFS (HR=0.595, 95%CI 0.447-0.792, p<0.0001). According to the cut-off values, subgroup analysis showed that AGR had significant prognostic effect on OS in each cut-off intervals (≤1.20, 1.20-1.40 and ≥1.40).Conclusion: Pre-treatment AGR is an effective prognostic factor and high AGR represents an ideal clinical outcome in the solid tumor patients.

Low Preoperative albumin-to-globulin ratio Predict Poor Survival and Negatively Correlated with Fibrinogen in Resectable Esophageal Squamous Cell Carcinoma.

Background: Although various inflammation-based indexes in esophageal carcinoma have been documented, but the prognostic value of the albumin-to-globulin ratio(AGR) and its correlation with fibrinogen in resectable ESCC remain unknown.Methods: The levels of pre-treatment serum common acute phase proteins (including CRP, albumin and fribrinogen) were retrospectively analyzed in 447 patients with ESCC who underwent surgical resection at our department. The prognostic value was explored by univariate and multivariate cox hazard analysis. The correlation between AGR and acute phase proteins were also analyzed.Results: Patients with decreased levels of AGR and increased CRP had significantly lower 5-year survival rates than those with higher AGR, not only in the whole ESCC cohort but also in the subgroups stratified according to the disease T, N classifications, and metastasis, whereas the other acute phase proteins were not independent prognostic factors for ESCC. In addition, a lower AGR level was observed more often in patients with a high fibrinogen level than in those with a low fibrinogen level. Spearman's rank correlation analysis revealed that the AGR level presented a negative correlation with the fibrinogen level (r =-0.317, p<0.001).Conclusions: The 5-year survival was shorter in resectable ESCC patients exhibiting decreased pre-treatment AGR and increased CRP. Thus, the serum AGR and CRP may be a clinical prognostic factor for resectable ESCC patients. In addition, a negative correlation was present between the levels of AGR and fibrinogen, the common indexes of acute phase reactants.

Clinical impact of preoperative albumin to globulin ratio in gastric cancer patients with curative intent

BackgroundLow albumin-to-globulin ratio (AGR) is associated with increased cancer mortality in patients with various cancers. However, there are no reports regarding the relation between pretreatment AGR and clinicopathological data, including oncological outcomes, in gastric cancer (GC) patients with curative intent. MethodsClinicopathological findings including preoperative laboratory data from 384 curative GC patients were assessed as indicators of early recurrence and poor prognosis in this retrospective study. AGR was calculated as albumin/(total protein − albumin)]. ResultsSeveral pathological categories related to tumor progression were associated with low AGR levels. Among preoperative serum markers, AGR was an independent predictor of early recurrence in curative GC patients. By multivariate analysis using both preoperative serum markers and postoperative clinicopathological categories, 2 pathological factors, lymph node metastasis and serosal invasion, and low AGR were independently associated with early recurrence. Furthermore, GC patients with low AGR showed significantly poor disease-free survival in the lymph node metastasis and serosal invasion groups. ConclusionsAGR was a novel independent predictor of early recurrence in curative GC patients.

Pretreatment albumin-to-globulin ratio as a predictive marker for tyrosine kinase inhibitor in non-small cell lung cancer.

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. 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. 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. 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.

Abstract 577: The albumin to globulin ratio predicts chemotherapeutic outcomes in patients with unresectable metastatic CRC

Abstract Background: Markers of the systemic inflammatory response have been recognized to correlate with prognosis in patients with various types of cancers. The pretreatment albumin to globulin ratio (AGR) has been reported to correlate with the long-term survival in patients with various cancers. However, there are no reports regarding the correlation between the pretreatment AGR and chemotherapeutic outcomes in patients with unresectable metastatic colorectal cancer. The aim of this study was to evaluate the prognostic significance of the pretreatment AGR in patients with unresectable metastatic colorectal cancer. Methods: A total of 66 patients with unresectable metastatic colorectal cancer who underwent palliative chemotherapy for metastatic tumors were enrolled. The AGR was calculated as follows: Albumin/(Total protein - Albumin). Results: The median pretreatment AGR was 1.254 (range: 0.849-1.840); we set 1.25 as the cut-off according to this value. Based on the cut-off value of 1.25, 34 patients were classified into the high-AGR group and 32 patients were classified into the low-AGR group. The high-AGR group had a significantly higher chemotherapeutic disease control rate (p = 0.040) and better progression-free survival (p = 0.0171) and overall survival (p = 0.0360) rates than the low-AGR group. Among the clinicopathological factors, the AGR was identified to be the only prognostic factor for progression-free survival (Hazard Ratio: 2.527, 95% Confidence Interval: 1.152-5.545, p = 0.021) and overall survival (Hazard Ratio: 1.946, 95% Confidence Interval: 1.033-3.668, p = 0.039). Conclusions: The pretreatment AGR is a useful prognostic marker in patients with unresectable metastatic colorectal cancer who receive palliative chemotherapy. Citation Format: Masatsune Shibutani, Kiyoshi Maeda, Hisashi Nagahara, Hiroshi Ohtani, Yasuhito Iseki, Tetsuro Ikeya, Kenji Sugano, Katsunobu Sakurai, Sadaaki Yamazoe, Kenjiro Kimura, Takahiro Toyokawa, Ryosuke Amano, Naoshi Kubo, Hiroaki Tanaka, Kazuya Muguruma, Masaichi Ohira, Kosei Hirakawa. The albumin to globulin ratio predicts chemotherapeutic outcomes in patients with unresectable metastatic CRC. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 577. doi:10.1158/1538-7445.AM2015-577

The pretreatment albumin to globulin ratio predicts chemotherapeutic outcomes in patients with unresectable metastatic colorectal cancer.

BackgroundThe pretreatment albumin to globulin ratio (AGR) has been reported to correlate with the long-term survival in patients with various cancers. However, there are no reports regarding the correlation between the pretreatment AGR and chemotherapeutic outcomes in patients with unresectable metastatic colorectal cancer. The aim of this study was to evaluate the prognostic significance of the pretreatment AGR in patients with unresectable metastatic colorectal cancer.MethodsA total of 66 patients with unresectable metastatic colorectal cancer who underwent palliative chemotherapy for metastatic tumors were enrolled. The AGR was calculated as follows: Albumin/(Total protein - Albumin).ResultsThe median pretreatment AGR was 1.254 (range: 0.849-1.840). We set 1.25 as the cut-off value based on the receiver operating characteristic curve. Based on the cut-off value of 1.25, 34 patients were classified into the high-AGR group and 32 patients were classified into the low-AGR group. The high-AGR group had a significantly higher chemotherapeutic disease control rate (p = 0.040) and better progression-free survival (p = 0.0171) and overall survival (p = 0.0360) rates than the low-AGR group. According to a multivariate analysis of survival, the AGR was identified to be an independent prognostic factor for progression-free survival (Hazard Ratio: 2.662, 95% Confidence Interval: 1.085-6.631, p = 0.033) and overall survival (Hazard Ratio: 2.247, 95% Confidence Interval: 1.069-4.722, p = 0.033).ConclusionsThe pretreatment AGR is a useful prognostic marker in patients with unresectable metastatic colorectal cancer who receive palliative chemotherapy.