预处理白蛋白-胆红素分级与EGFR-TKIs治疗非小细胞肺癌的肝毒性和疗效的相关性
Association of Pretreatment Albumin-bilirubin Grade With Hepatotoxicity and Efficacy in EGFR-TKIs Therapy for NSCLC.
作者信息
Arihara Hiroki, Nagamatsu Hidetsugu, Hayakawa Yuji, Mase Hiroki, Araya Tomoyuki, Kita Toshiyuki
机构信息
Department of Clinical Pharmacy and Healthcare Science, Faculty of Pharmacy, Institute of Medical, Pharmaceutical and Health Science, Kanazawa University, Kanazawa, Japan.
Department of Clinical Research, National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan.
出版信息
Cancer Diagn Progn. 2025 Jan 3;5(1):95-104. doi: 10.21873/cdp.10417. eCollection 2025 Jan-Feb.
BACKGROUND/AIM: The albumin-bilirubin (ALBI) grade is an assessment tool for hepatic function and prognosis in patients with hepatocellular carcinoma (HCC). However, its significance in patients with non-small cell lung cancer (NSCLC) treated with an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) remains unclear. We retrospectively investigated the relationship between pre-treatment ALBI grade and hepatotoxicity and treatment efficacy in patients with NSCLC receiving EGFR-TKIs.
PATIENTS AND METHODS
We analyzed data from 182 patients with NSCLC treated with EGFR-TKIs. Patients were categorized into ALBI grades 1/2a and 2b/3 groups. We examined the association between ALBI grade, hepatotoxicity, and time to treatment failure (TTF) using univariate and multivariate analyses.
RESULTS
In the univariate Kaplan-Meier analysis, ALBI grade was not associated with hepatotoxicity (log-rank p=0.56). This finding was consistent with the multivariate analysis of patients treated with gefitinib and erlotinib (n=158). However, In the univariate Kaplan-Meier analysis, the median TTF for the ALBI grade 1/2a group was 10.6 months, compared to 5.8 months for the ALBI grade 2b/3 group (hazard ratio=1.66, 95% confidence interval=1.19-2.33, p=0.003). Multivariate analysis confirmed that ALBI grade 2b/3 (hazard ratio=1.64, 95% confidence interval=1.16-2.30, p<0.01) was independently associated with shortened TTF.
CONCLUSION
Pretreatment ALBI grade classification can predict efficacy in patients with NSCLC treated with EGFR-TKIs.
背景/目的：白蛋白-胆红素（ALBI）分级是评估肝细胞癌（HCC）患者肝功能及预后的一种工具。然而，其在接受表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）治疗的非小细胞肺癌（NSCLC）患者中的意义尚不清楚。我们回顾性研究了接受EGFR-TKIs治疗的NSCLC患者治疗前ALBI分级与肝毒性及治疗疗效之间的关系。
患者与方法
我们分析了182例接受EGFR-TKIs治疗的NSCLC患者的数据。患者被分为ALBI 1/2a级和2b/3级组。我们采用单因素和多因素分析研究了ALBI分级、肝毒性和治疗失败时间（TTF）之间的关联。
结果
在单因素Kaplan-Meier分析中，ALBI分级与肝毒性无关（对数秩检验p = 0.56）。这一结果与吉非替尼和厄洛替尼治疗患者（n = 158）的多因素分析结果一致。然而，在单因素Kaplan-Meier分析中，ALBI 1/2a级组的中位TTF为10.6个月，而ALBI 2b/3级组为5.8个月（风险比=1.66，95%置信区间=1.19 - 2.33，p = 0.003）。多因素分析证实，ALBI 2b/3级（风险比=1.64，95%置信区间=1.16 - 2.30，p < 0.01）与TTF缩短独立相关。
结论
治疗前ALBI分级可预测接受EGFR-TKIs治疗的NSCLC患者的疗效。
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