Albumin - globulin ratio and Eosinophil-neutrophil ratio as potential
predictive biomarkers for Anti-PD-1/PD-L1 treatment in advanced
Purpose To investigate the predictive value of peripheral serum
biomarkers such as albumin - globulin ratio (AGR) and eosinophilic -
neutrophil ratio (ENR) in the advanced malignant tumors with
anti-PD-1/PD-L1. Methods We retrospectively analyzed the clinical
efficacy of 95 patients with advanced metastatic malignancies treated
with PD-1/PD-L1 inhibitor from January 1, 2017 to May 1, 2020 in our
cancer center. The predictive value of baseline AGR, baseline ENR,
baseline neutrophil-lymphocyte ratio (NLR) and other serum biomarkers
was evaluated. We also develop a risk scoring tool and draw a Nomogram.
Results The disease control rate was 64.2%, and the median
progression-free survival(PFS) was 108 days. Univariate COX analysis
showed that age, NLR, Eastern Cooperative Oncology Group (ECOG)
performance status (PS), platelet-neutrophil ratio (PLR), ENR, AGR),
LDH, treatment lines, and treatment were closely correlated with PFS.
Multivariate COX analysis showed that age, AGR, ENR, and treatment were
independent prognostic factors for PFS. The low-risk group
(-4~0 points) had significantly higher PFS than the
high-risk group (1~3 points) when the risk scoring tool
was constructed based on COX regression model. The Nomogram Concordia
Index (C-index) with independent prognostic factors was 0.716.
Conclusions Baseline AGR and baseline ENR may be effective biomarkers
for predicting the efficacy of anti-PD-1/PD-L1 in the advanced malignant
tumors, and their clinical value needs to be verified by further
large-sample and prospective studies.