Serum lactate dehydrogenase as an early marker for outcome in patients treated with anti-PD-1 therapy in metastatic melanoma
Open accessAbstract
BACKGROUND: Treatment with programmed death receptor-1 (PD-1) antibodies is associated with high response rates in patients with advanced melanoma. Reliable markers for early response and outcome are still sparse. METHODS: We evaluated 66 consecutive patients with advanced/metastatic melanoma treated with nivolumab or pembrolizumab between 2013 and 2014. The main objectives of this study were to investigate whether, first, serum lactate dehydrogenase (LDH) at baseline (normal vs above the upper limit of normal) correlates with overall survival (OS), and, second, whether the change of LDH during treatment predicts response before the first scan and OS in patients with an elevated baseline LDH. RESULTS: After a median follow-up of 9 months, patients with an elevated baseline LDH (N=34) had a significantly shorter OS compared with patients with normal LDH (N=32; 6-month OS: 60.8% vs 81.6% and 12-month OS: 44.2% vs 71.5% (log-rank P=0.0292). In those 34 patients with elevated baseline LDH, the relative change during treatment was significantly associated with an objective response on the first scan: the 11 (32%) patients with partial remission had a mean reduction of -27.3% from elevated baseline LDH. In contrast, patients with progressive disease (N=15) had a mean increase of +39%. Patients with a relative increase over 10% from elevated baseline LDH had a significantly shorter OS compared with patients with ⩽ 10% change (4.3 vs 15.7 months, log-rank P<0.00623). CONCLUSIONS: LDH could be a useful marker at baseline and during treatment to predict early response or progression in patients with advanced melanoma who receive anti-PD-1 therapy.
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A reduction in LDH levels after treatment is associated with improved response.
“A reduction in LDH levels after treatment is also associated with improved response (104).”
From Anti-PD-1 and Anti-CTLA-4 Therapies in Cancer: Mechanisms of Action, Efficacy, and Limitations (2018) · cites this paper as [104]
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- Authors
- Diem, S., Kasenda, B., Spain, L., Martin-Liberal, J., Marconcini, R., Gore, M., & Larkin, J.
- Affiliations
- Royal Marsden NHS Foundation Trust (GB)
- Corresponding author
- Larkin, J
- Venue
- British Journal of Cancer
- Published
- 2016-01-21
- Volume
- 114
- Issue
- 3
- Pages
- 256-261
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC4742588
- OpenAlex
- W2396808887
- Cited by
- 308
- References
- 32
- Citations by year
- 2026: 14 · 2025: 11 · 2024: 22 · 2023: 17 · 2022: 33 · 2021: 48 · 2020: 46 · 2019: 38 · 2018: 33 · 2017: 34 · 2016: 12
- FWCI
- 21.01
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- Funders
- NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Keywords
- serum lactate dehydrogenase, metastatic melanoma, anti-PD-1 therapy, nivolumab, pembrolizumab, predictive biomarkers, overall survival, treatment response prediction, tumor progression, immune checkpoint inhibitors
- MeSH terms
- Nivolumab, Aged, Antibodies, Monoclonal, Antineoplastic Agents, Female, Humans, L-Lactate Dehydrogenase, Male, Melanoma, Middle Aged, Neoplasm Metastasis, Prognosis, Retrospective Studies, Skin Neoplasms, Cohort Studies, Survival Rate, Treatment Outcome, Programmed Cell Death 1 Receptor, Antibodies, Monoclonal, Humanized
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