Prognostic significance of pre-treatment albumin-bilirubin grade in metastatic urothelial carcinoma receiving pembrolizumab

• Published in: Japanese journal of clinical oncology 2023-08, Vol.53 (9), p.845-850
• Main Authors: Yamashita, Shimpei, Wada, Takuma, Deguchi, Ryusuke, Mashima, Nobuyuki, Higuchi, Masatoshi, Miyai, Haruka, Koike, Hiroyuki, Kohjimoto, Yasuo, Hara, Isao
• Format: Article
• Language: English
• ISSN: 1465-3621; 1465-3621
• DOI: 10.1093/jjco/hyad069

Abstract Background Pre-treatment albumin-bilirubin grade is a useful biomarker for predicting prognosis in patients receiving immune checkpoint inhibitors for advanced malignancies. We evaluated the prognostic impact of pre-treatment albumin-bilirubin grade in patients receiving pembrolizumab for metastatic urothelial carcinoma. Methods In this multicenter retrospective study, we calculated pre-treatment albumin-bilirubin scores of 96 patients who received pembrolizumab for metastatic urothelial carcinoma between January 2018 and March 2022. Patients were classified according to albumin-bilirubin grade. Progression-free survival and cancer-specific survival were compared between the groups. To evaluate the prognostic impact of pre-treatment albumin-bilirubin grade, we also performed Cox proportional regression analyses for progression-free survival and cancer-specific survival. Results The median pre-treatment albumin bilirubin score was −2.52 (quartile: −2.76 to −2.10), and albumin-bilirubin grade was grade 1 in 37 patients (39%), grade 2a in 30 patients (31%), 2b in 22 patients (23%) and grade 3 in 7 patients (7%). The median progression-free survival and cancer-specific survival were 2 and 7 months, respectively. Progression-free survival and cancer-specific survival were significantly different between the albumin-bilirubin grade groups (P