The Association Between Albumin Levels and Survival in Patients Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-analysis

The albumin levels could be used as a prognostic biomarker in cancer patients treated with immune checkpoint inhibitors (ICIs) due to close relations with nutritional and inflammatory status. Therefore, we conducted a systematic review and meta-analysis to evaluate the association between survival outcomes and albumin levels in patients treated with ICIs. We conducted a systematic review from the Pubmed, Medline, and Embase databases to filter the published studies until until to 1 June 2022. Thirty-six studies encompassing 8406 cancer patients with advanced disease were included in the meta-analyses. The patients with lower albumin levels had significantly increased risk of death (HR: 1.66, 95% CI:1.52–1.81, p < 0.0001) than patients with higher albumin levels and had increased risk of progression or death compared to patients with higher albumin levels (HR: 1.74, 95% CI:1.39–2.17, p < 0.001). The available evidence demonstrates that albumin levels could be a prognostic biomarker in advanced cancer patients treated with ICIs.