Abstract
The main aim of this study is to investigate whether baseline lactate dehydrogenase (LDH) is associated with the clinical outcome of non small‐cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs). We searched Pubmed, the Cochrane Central library and Embase for peripheral blood biomarker of LDH in advanced NSCLC patients treated with ICIs. We extracted the hazard ratio (HR) with 95% confidence interval (CI) for the progression free survival (PFS) and overall survival (OS) and performed meta‐analysis of HR. Pooled estimates of treatment outcomes were calculated by stata 15.1. Six studies with 1136 patients were included in this study. The pooled results of univariate analysis suggested that an elevated pretreatment LDH level was correlated with significant shorter PFS (HR = 1.53, 95% CI 1.27‐1.83, P < 0.001) and OS (HR = 2.11, 95% CI 1.43‐3.11, P < 0.001). The association remained significant in the multivariate analysis that elevated pretreatment LDH level was associated with poor PFS (HR = 1.62, 95% CI 1.26‐2.08, P < 0.001) and OS (HR = 2.38, 95% CI 1.37‐4.12, P = 0.002). A high pretreatment LDH level was significantly correlated with shorter PFS and OS. Pretreatment LDH may serve as a predictive biomarker for advanced NSCLC patients treated with ICIs.
Highlights
Cancer continues to be the most threatening disease to human health.[1]
Our results suggest that a high pretreatment lactate dehydrogenase (LDH) level was significantly correlated with poor survival and a baseline serum LDH may serve as a potential predictive biomarker for Non small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs)
The following articles were included in the analysis: (a) Human studies investigated NSCLC patients receiving ICIs treatment; (b) Determination of the relationship between baseline LDH level and prognosis; (c) Hazard ratio (HR) with 95% confidence interval (CI) were presented for overall survival (OS) and/or progression free survival (PFS); (d) If the same population was used by two or more studies, only the one with the largest sample size and latest information was included; (e) the full text was available
Summary
Cancer continues to be the most threatening disease to human health.[1]. Lung cancer remains the most frequent cause of cancer related death worldwide and affects over 1.8 million patients per year.[2]. Recent studies have demonstrated that elevated pretreatment level of LDH is associated with poor outcome in several cancer types and baseline LDH level may predict the prognosis of patients treated with ICIs.[5-7]. The predictive role of LDH in NSCLC patients treated with ICIs is uncertain. We conduct this meta‐analysis to identify whether baseline LDH level is correlated with the outcome of advanced NSCLC patients treated with ICIs. Our results suggest that a high pretreatment LDH level was significantly correlated with poor survival and a baseline serum LDH may serve as a potential predictive biomarker for NSCLC patients treated with ICIs
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