The association between HALP score and survival in patients treated with immune checkpoint inhibitors

Background: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score could be a prognostic biomarker in patients with cancer as a reflector of nutritional and inflammatory status, although the data is limited in patients treated with immune-checkpoint inhibitors (ICIs). Therefore, we sought to investigate the relationship between HALP score and survival in ICI-treated patients.

Methods: We included adult patients with advanced cancer treated with ICIs between June 2016 and January 2024. Receiver operating characteristic (ROC) curve analysis was employed to identify the optimal HALP score cutoff point for survival prediction. The Kaplan-Meier method was utilized to create survival curves, and Cox regression was employed for multivariate analysis.

Results: A total of 456 patients were included. The median age was 62 years, and 64.7% were male. The optimal HALP cutoff value for survival prediction was 22.8 in ROC analyses (AUC: 0.624, 95% CI: 0.570-0.679, p < 0.001). Multivariate analysis revealed that patients with low HALP scores had significantly shorter OS (HR: 1.394, 95% CI: 1.077-1.805, p = 0.012) and PFS (HR: 1.388, 95% CI: 1.129-1.706, p = 0.002).

Conclusions: Our study results pointed out the possible use of the HALP score as a prognostic marker in ICI-treated patients. If validated in prospective cohorts, the HALP score could enhance prognosis prediction in ICI-treated patients.