JCHOR
Journal of Current Hematology & Oncology Research

The Journal of Current Hematology & Oncology Research regularly publishes internationally qualified research in hematology and oncology within the current scholarly knowledge.

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Original Article
The predictive and prognostic value of the Advanced Lung Cancer Inflammation Index in metastatic NSCLC receiving second-line nivolumab: a multicenter retrospective cohort study
Abstract
Aims: The Advanced Lung Cancer Inflammation Index (ALI)—calculated from body mass index (BMI), serum albumin, and neutrophil-to-lymphocyte ratio (NLR)—is an accessible composite biomarker of systemic inflammation and nutritional status. Its prognostic value in second-line immune checkpoint inhibitor (ICI) therapy in an ICI-naive population remains undefined.
Methods: This multicenter retrospective cohort study included 249 metastatic non-small cell lung cancer (NSCLC) patients treated with second-line single-agent nivolumab without prior immunotherapy exposure. ALI was categorized using a receiver operating characteristic (ROC)-derived cut-off of 27.27. Treatment response was assessed by RECIST 1.1. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier and Cox regression models.
Results: High baseline ALI (>=27.27) was associated with significantly longer median PFS (10.05 vs. 6.01 months; p=0.012) and OS (13.89 vs. 6.27 months; p<0.001). In multivariable analyses, high ALI remained independently associated with improved PFS (HR 0.688; p=0.011) and OS (HR 0.585; p=0.002). The overall objective response rate (ORR) was 35.3% and disease control rate (DCR) was 43.0%; both were numerically higher in the high-ALI group but did not reach statistical significance, and no significant differences were observed in objective response rates.
Conclusion: Baseline ALI is an independent prognostic biomarker for PFS and OS in ICI-naive metastatic NSCLC patients receiving second-line nivolumab, representing a cost-effective tool for pre-treatment risk stratification. Prospective validation is warranted.

Keywords : Non-small cell lung cancer, Advanced Lung Cancer Inflammation Index, nivolumab, immunotherapy, prognosis, biomarker

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1. Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics Review 1975-2009. Bethesda, MD: National Cancer Institute; 2009.
2. Sandler A, Gray R, Perry MC, et al. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med. 2006;355(8): 2542-2550. doi:10.1056/NEJMoa061884
3. Herbst RS, Baas P, Kim DW, et al. Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial. Lancet. 2016; 387(10027):1540-1550. doi:10.1016/S0140-6736(15)01281-7
4. Borghaei H, Paz-Ares L, Horn L, et al. Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer. N Engl J Med. 2015;373(17):1627-1639. doi:10.1056/NEJMoa1507643
5. Brahmer J, Reckamp KL, Baas P, et al. Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer. N Engl J Med. 2015;373(2):123-135. doi:10.1056/NEJMoa1504627
6. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454(7203):436-444. doi:10.1038/nature07205
7. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144(5):646-674. doi:10.1016/j.cell.2011.02.013
8. Jafri SH, Shi R, Mills G. Advance lung cancer inflammation index (ALI) at diagnosis is a prognostic marker in patients with metastatic non-small cell lung cancer (NSCLC): a retrospective review. BMC Cancer. 2013;13:158. doi:10.1186/1471-2407-13-158
9. Lu P, Ma Y, Kai J, et al. A low Advanced Lung Cancer Inflammation Index predicts a poor prognosis in patients with metastatic non-small cell lung cancer. Front Mol Biosci. 2022;8:784667. doi:10.3389/fmolb.2021.784667
10. Han Z, Hu Z, Zhao Q, Xue W, Duan G. The Advanced Lung Cancer Inflammation Index predicts outcomes of patients with non-small cell lung cancer following video-assisted thoracic surgery. J Int Med Res. 2021;49(12):3000605211062442. doi:10.1177/03000605211062442
11. Gregersen CH, Aggerholm-Pedersen N, Sandfeld-Paulsen B, Winther-Larsen A. Advanced Lung Cancer Inflammation Index has prognostic impact in stage I non-small cell lung cancer: a registry-based analysis of 934 patients. Clin Lung Cancer. 2026;27(1):24-33. doi:10.1016/j.cllc.2025.10.013
12. Mountzios G, Samantas E, Senghas K, et al. Association of the Advanced Lung Cancer Inflammation Index (ALI) with immune checkpoint inhibitor efficacy in patients with advanced non-small-cell lung cancer. ESMO Open. 2021;6(5):100254. doi:10.1016/j.esmoop.2021.100254
13. Ozyurek BA, Ozdemirel TS, Ozden SB, et al. Does advanced Lung Inflammation Index (ALI) have prognostic significance in metastatic non-small cell lung cancer? Clin Respir J. 2018;12(6):2013-2019. doi:10.1111/crj.12768
14. Bacha S, Sghaier A, Habibech S, et al. Advanced Lung Cancer Inflammation Index: a prognostic score in patients with metastatic non-small cell lung cancer. Tunis Med. 2017;95(11):976-981.
15. Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ. Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Br J Cancer. 2003;89(6):1028-1030. doi:10.1038/sj.bjc.6601242
Article available in :
Volume 4, Issue 3, 2026
Page : 86-92
https://doi.org/10.51271/JCHOR-0088
Article Information
Received : 09 May 2026
Accepted : 15 Haz 2026
Published : 08 Ağu 2026
Corresponding Author :

Ali Aytaç: Department of Medical Oncology, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkiye

[email protected]
Citation : Aytaç A, Demir B, Canaslan K, Ellez Hİ, Aydınalp Camadan Y. The predictive and prognostic value of the Advanced Lung Cancer Inflammation Index in metastatic NSCLC receiving second-line nivolumab: a multicenter retrospective cohort study. J Curr Hematol Oncol Res. 2026;4(3):86-92. doi:10.51271/JCHOR-0088

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