{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:46:03Z","timestamp":1785735963825,"version":"3.56.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"\n Background<\/jats:title>\n Although immune checkpoint inhibitors (ICIs) have revolutionized advanced non-small cell lung cancer (NSCLC) treatment, clinical benefits vary. This study evaluated the predictive value of baseline nutritional and hematological markers for ICI efficacy and survival.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A retrospective cohort of 124 advanced NSCLC patients receiving ICIs was evaluated. Patients were stratified by median cut-offs: prognostic nutritional index (PNI: 45), albumin (ALB: 40.2\u202fg\/L), body mass index (BMI: 20.1\u202fkg\/m\n 2<\/jats:sup>\n ), and hemoglobin (Hb: 114\u202fg\/L). Independent predictors of binary short-term efficacy outcomes (ORR and DCR) and time-to-event long-term survival outcomes (PFS and OS) were identified using multivariate logistic regression and Cox proportional hazards regression models.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n High baseline PNI and ALB were significantly associated with superior objective response and disease control rates (DCR). Multivariate analyses confirmed PNI (OR\u202f=\u202f1.377,\n p<\/jats:italic>\n \u202f=\u202f0.014) and ALB (OR\u202f=\u202f1.840,\n p<\/jats:italic>\n \u202f=\u202f0.003) as independent protective factors for DCR, alongside independent associations with prolonged progression-free and overall survival (OS) (all\n p<\/jats:italic>\n \u202f&lt;\u202f0.05). BMI lost independent predictive value after multivariate adjustment. The combined PNI\u202f+\u202fALB model consistently outperformed single markers, achieving 12-, 24-, and 36-month OS area under the curve (AUC) values of 0.802, 0.819, and 0.807, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Baseline PNI and ALB are non-invasive, independent predictors of short-term response and long-term survival in advanced NSCLC patients undergoing immunotherapy. Combining these markers improves prognostic discrimination.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fnut.2026.1882630","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:31:05Z","timestamp":1785735065000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive value of nutritional biomarkers for immune checkpoint inhibitor efficacy in patients with non-small cell lung cancer"],"prefix":"10.3389","volume":"13","author":[{"given":"Wentao","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, Southeast University Affiliated Xuzhou Central Hospital","place":["Xuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Southeast University Affiliated Xuzhou Central Hospital","place":["Xuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1186\/s12885-020-07690-8","article-title":"Clinically relevant prognostic and predictive markers for immune-checkpoint-inhibitor (ICI) therapy in non-small cell lung cancer (NSCLC)","volume":"20","author":"Brueckl","year":"2020","journal-title":"BMC Cancer"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1001\/jamaoncol.2016.0639","article-title":"Biomarkers for the clinical use of PD-1\/PD-L1 inhibitors in non-small-cell lung cancer: a review","volume":"2","author":"Sacher","year":"2016","journal-title":"JAMA Oncol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s40164-021-00211-8","article-title":"Predictive biomarkers of anti-PD-1\/PD-L1 therapy in 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PD-1\/PD-L1","volume":"26","author":"Shao","year":"2024","journal-title":"Clin Transl Oncol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2098","DOI":"10.7150\/thno.48027","article-title":"Assessing PD-L1 expression in non-small cell lung cancer and predicting responses to immune checkpoint inhibitors using deep learning on computed tomography images","volume":"11","author":"Tian","year":"2021","journal-title":"Theranostics"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1186\/s13046-022-02379-1","article-title":"Extracellular vesicle PD-L1 dynamics predict durable response to immune-checkpoint inhibitors and survival in patients with non-small cell lung cancer","volume":"41","author":"de Miguel-Perez","year":"2022","journal-title":"J Exp Clin Cancer Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1764","DOI":"10.1111\/1759-7714.15401","article-title":"The association of nutritional and inflammatory biomarkers with overall 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of overall and elderly populations","volume":"61","author":"Alan","year":"2025","journal-title":"Medicina (Kaunas)"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1327449","DOI":"10.3389\/fimmu.2024.1327449","article-title":"Serum albumin and derived neutrophil-to-lymphocyte ratio are potential predictive biomarkers for immune checkpoint inhibitors in small cell lung cancer","volume":"15","author":"Kuang","year":"2024","journal-title":"Front Immunol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"e7110","DOI":"10.1002\/cam4.7110","article-title":"Body composition change indices combined with prognostic nutritional index predicts the clinical outcomes of patients with gastric cancer treated with immune checkpoint inhibitor","volume":"13","author":"Deng","year":"2024","journal-title":"Cancer Med"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1636","DOI":"10.1093\/pm\/pnz325","article-title":"Association of body mass index and serum markers of 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The role of lactate dehydrogenase for postoperative pain prediction","volume":"21","author":"Gonzalez-Callejas","year":"2020","journal-title":"Pain Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1041140","DOI":"10.3389\/fonc.2023.1041140","article-title":"Use of the prognostic nutrition index as a predictive biomarker in small-cell lung cancer patients undergoing immune checkpoint inhibitor treatment in the Chinese alpine region","volume":"13","author":"Wu","year":"2023","journal-title":"Front Oncol"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1882630\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:31:06Z","timestamp":1785735066000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1882630\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":38,"alternative-id":["10.3389\/fnut.2026.1882630"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1882630","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]},"article-number":"1882630"}}