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. 2022 Jul 18:12:791496.
doi: 10.3389/fonc.2022.791496. eCollection 2022.

The Predictive Value of Pretreatment Lactate Dehydrogenase and Derived Neutrophil-to-Lymphocyte Ratio in Advanced Non-Small Cell Lung Cancer Patients Treated With PD-1/PD-L1 Inhibitors: A Meta-Analysis

Qianning Zhang  1   2 , Xiaoling Gong  1   2 , Lei Sun  1   2 , Liyun Miao  3 , Yujie Zhou  3
Affiliations

The Predictive Value of Pretreatment Lactate Dehydrogenase and Derived Neutrophil-to-Lymphocyte Ratio in Advanced Non-Small Cell Lung Cancer Patients Treated With PD-1/PD-L1 Inhibitors: A Meta-Analysis

Qianning Zhang et al. Front Oncol. .

Abstract

Background: The Lung Immune Prognostic Index (LIPI) combines the lactate dehydrogenase (LDH) level and the derived neutrophil-to-lymphocyte ratio (dNLR). A lot of studies have shown that LDH and dNLR are associated with the prognosis of advanced non-small cell lung cancer (NSCLC) in patients treated with programmed cell death protein 1 (PD-1) or programmed death-ligand 1 (PD-L1) inhibitors. However, previous results were inconsistent, and the conclusions remain unclear. This meta-analysis aimed to investigate the predictive value of pretreatment LDH and dNLR for NSCLC progression in patients treated with PD-1/PD-L1 inhibitors.

Methods: PubMed, Embase, and the Cochrane Library were searched by two researchers independently for related literature before March 2020. Hazard ratios (HRs) with 95% confidence intervals (CIs) for progression-free survival (PFS) and overall survival (OS) were extracted to assess the predictive value of LDH and dNLR. STATA 15. 0 was used to perform the meta-analysis.

Results: A total of 3,429 patients from 26 studies were included in this meta-analysis. The results revealed that high pretreatment LDH was related to poor OS (HR = 1.19, 95%CI = 1.11-1.24, p < 0.001), but not closely related to poor PFS (HR = 1.02, 95%CI = 1.00-1.04, p = 0.023 < 0.05). The pooled results for dNLR suggested that high pretreatment dNLR was related to poor OS (HR = 1.55, 95%CI = 1.33-1.80, p < 0.001) and PFS (HR = 1.33, 95%CI = 1.16-1.54, p < 0.001).

Conclusion: Both pretreatment LDH and dNLR have the potential to serve as peripheral blood biomarkers for patients with advanced NSCLC treated with PD-1/PD-L1 inhibitors. However, more studies on LDH are needed to evaluate its predictive value for PFS in patients with NSCLC.

Keywords: derived neutrophil-to-lymphocyte ratio; immunotherapy; lactate dehydrogenase; non-small cell lung cancer; prognosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the included studies.
Figure 2
Figure 2
(A) Forest plots of the association between pretreatment lactate dehydrogenase (LDH) and progression-free survival. (B) Forest plots of the association between pretreatment LDH and overall survival.
Figure 3
Figure 3
(A) Forest plots of the association between pretreatment derived neutrophil-to-lymphocyte ratio (dNLR) and progression-free survival. (B) Forest plots of the association between pretreatment dNLR and overall survival.
See this image and copyright information in PMC

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