Predictive value of HALP score for clinical outcomes in lung cancer patients: a systematic review and meta-analysis

The hemoglobin-albumin-lymphocyte-platelet (HALP) index has emerged as a composite indicator reflecting nutritional and inflammatory status. Its prognostic relevance in lung cancer remains inconsistent across studies. This study quantitatively evaluated the association between pretreatment HALP levels and clinical outcomes in lung cancer.

Several electronic databases were searched up to April 7, 2025. Primary endpoints included overall survival (OS) and progression-free survival (PFS). Secondary endpoints consisted of disease control rate (DCR), objective response rate (ORR), 90-day mortality, and cachexia. Hazard ratios (HRs) and odds ratios (ORs) were combined for the primary and secondary outcomes, respectively. Subgroup analyses based on tumor type and treatment were performed.

Sixteen studies were enrolled. Pooled results indicated that lower HALP score significantly predicted worse OS [HR =0.60; 95% confidence interval (CI): 0.50-0.73; P<0.001] and PFS (HR =0.52; 95% CI: 0.39-0.69; P<0.001). Subgroup analysis manifested similar results. For the secondary outcomes, pretreatment HALP score was also related to 90-day mortality (OR =0.35; 95% CI: 0.24-0.51; P<0.001) and cachexia (OR =0.76; 95% CI: 0.61-0.95; P=0.02). However, non-significant association of pretreatment HALP score with DCR (OR =1.85; P=0.06) or ORR (OR =1.01; P=0.96) was observed.

Pretreatment HALP score might serve as a novel predictor for clinical outcomes in lung cancer and a lower HALP score predicts worse prognosis.