In the present study, multivariate analysis showed that the ALB <35 g/L was correlated with shorter PFS (3.0 months vs. 6.9 months, P < 0.001) and 1-year survival rates (28.6% vs. 72.8%, P < 0.001) compared with ALB ≥35 g/L in NSCLC receiving ICIs, which is consistent with previous findings that high ALB levels are associated with poor outcomes in various cancers, including melanoma, pancreatic cancer, lung cancer, gastric cancer, and breast cancer [22]. This evidence concerns the gene ALB and familial pancreatic carcinoma.