Rosique-Aznar Claudia, Valcuende-Rosique Alejandro, Rosique-Robles Dolores, Sánchez-Alcaraz Agustín
Facultad de Farmacia, Universidad de Murcia, Murcia, Spain.
Servicio de Farmacia, Hospital Universitario de la Ribera, Alzira, Spain.
Farm Hosp. 2025 May-Jun;49(3):T143-T147. doi: 10.1016/j.farma.2024.11.007. Epub 2025 Jan 29.
The expression level of programmed death ligand 1 (PD-L1) is the only approved biomarker for predicting response to immunotherapy, yet its efficacy is not always consistent. Lactate dehydrogenase (LDH) has been associated with tumor aggressiveness and poorer prognosis across various cancer types and may serve as a useful biomarker for monitoring treatment response. The objective of this study is to analyze the relationship between LDH levels prior to the start of treatment with immune checkpoint inhibitors (ICIs) and clinical outcomes in patients with non-small cell lung cancer (NSCLC).
A retrospective study was conducted including patients diagnosed with NSCLC who were treated with at least 3 cycles of immunotherapy. Data on demographics, clinical and pathological characteristics, treatment received, pretreatment LDH levels, and clinical outcomes such as treatment response and overall survival (OS) were analyzed.
A total of 181 patients diagnosed with NSCLC were included. Elevated pretreatment LDH levels (>244 U/L) were associated with significantly reduced OS. The median survival was 548 days in patients with LDH ≤ 244 U/L, compared to 332 days in those with LDH > 244 U/L (P = .037). Among men, OS was greater in the LDH ≤ 244 U/L group (623 days) versus 332 days in the LDH > 244 U/L group (P = 0.043). In patients with metastatic disease, OS was higher in those with LDH ≤ 244 U/L (474 days) compared to 249 days in those with LDH > 244 U/L (P = .023). In patients receiving both immunotherapy and chemotherapy, OS was greater in those with LDH ≤ 244 U/L (623 days) compared to 281 days in the LDH > 244 U/L group (P = .042).
High levels of LDH prior to the start of treatment with ICIs are associated with lower treatment efficacy and a worse prognosis of the disease, especially in male, metastatic patients with a PD-L1 expression level <1%.
程序性死亡配体1（PD-L1）的表达水平是唯一被批准用于预测免疫治疗反应的生物标志物，但其疗效并不总是一致。乳酸脱氢酶（LDH）与多种癌症类型的肿瘤侵袭性和较差预后相关，可能是监测治疗反应的有用生物标志物。本研究的目的是分析免疫检查点抑制剂（ICI）治疗开始前LDH水平与非小细胞肺癌（NSCLC）患者临床结局之间的关系。
进行一项回顾性研究，纳入诊断为NSCLC且接受至少3个周期免疫治疗的患者。分析人口统计学、临床和病理特征、接受的治疗、治疗前LDH水平以及治疗反应和总生存期（OS）等临床结局的数据。
共纳入181例诊断为NSCLC的患者。治疗前LDH水平升高（>244 U/L）与OS显著降低相关。LDH≤244 U/L的患者中位生存期为548天，而LDH>244 U/L的患者为332天（P = 0.037）。在男性中，LDH≤244 U/L组的OS更长（623天），而LDH>244 U/L组为332天（P = 0.043）。在转移性疾病患者中，LDH≤244 U/L的患者OS更高（474天），而LDH>244 U/L的患者为249天（P = 0.023）。在接受免疫治疗和化疗的患者中，LDH≤244 U/L的患者OS更长（623天），而LDH>244 U/L组为281天（P = 0.042）。
ICI治疗开始前LDH水平高与治疗效果降低和疾病预后较差相关，尤其是在PD-L1表达水平<1%的男性转移性患者中。
