Serum albumin and other prognostic factors related to response and survival in patients with advanced non-small cell lung cancer

The standard therapy for advanced non-small cell lung cancer (NSCLC) remains to be defined. The poor results from chemotherapy have favored the search for prognostic factors that help identify patients more likely to respond. Our objective was to find factors related to response, the duration of response, and overall survival in patients with advanced NSCLC. We reviewed the clinical records of 292 patients with non-operable NSCLC, all of whom had a good performance status and had received chemotherapy. Ninety percent were male and the median age was 59 years. The therapeutic regimens included MACC (methotrexate, adriamycin, cyclophosphamide and CCNU), cisplatin + vindesine or etoposide, MIP (mitomycin, ifosfamide and cisplatin) and MVP (mitomycin, vindesine and cisplatin). In the multivariate analysis, a normal albumin level and the inclusion of cisplatin were related to the achievement of a response (40% if both favorable factors were present). No factors appeared related to the duration of response. The following factors were predictive for survival: weight loss, performance status, lymphocyte count, albumin level, number of metastases and the presence of bone metastases. We conclude that the albumin level identifies a group of patients with advanced NSCLC who are more likely to respond to cisplatin-containing chemotherapy.