Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan-Dec:30:10732748221148912.
doi: 10.1177/10732748221148912.

Pretreatment Serum Lactate Dehydrogenase and Metastases Numbers as Potential Determinants of Anti-PD-1 Therapy Outcome in Nasopharyngeal Carcinoma

Wael A S Ali  1 , Xinxin Huang  2 , Yuehan Wu  3 , Yuxiang Ma  1 , Hui Pan  1 , Jun Liao  1 , Zhang Yang  3 , Shaodong Hong  1 , Yunpeng Yang  1 , Yan Huang  1 , Yuanyuan Zhao  1 , Wenfeng Fang  1 , Hongyun Zhao  3 , Li Zhang  1
Affiliations

Pretreatment Serum Lactate Dehydrogenase and Metastases Numbers as Potential Determinants of Anti-PD-1 Therapy Outcome in Nasopharyngeal Carcinoma

Wael A S Ali et al. Cancer Control. 2023 Jan-Dec.

Abstract

Background: We aimed to investigate the determinant factors of anti-PD-1 therapy outcome in nasopharyngeal carcinoma (NPC).

Methods: In this retrospective study, we included 64 patients with recurrent/metastatic NPC. The association of patients' characteristics, C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR), and lactate dehydrogenase (LDH) with survival benefit of anti-PD-1 therapy were analyzed using Cox regression models and Kaplan-Meier analyses. Patients were divided based on the median value of CRP, NLR or LDH into different subgroups.

Results: At a median follow-up time of 11.4 months (range: 1-28 months), median progression-free survival (PFS) and overall survival (OS) were 1.9 months (95% CI, .18-3.6) and 15 months (95% CI, 10.9-19.1) months, respectively. Pretreatment metastases numbers was significant predictor of PFS (HR = 1.99; 95% CI 1.10-3.63; P = .024) and OS (HR = 2.77; 95% CI 1.36-5.61; P = .005). Baseline LDH level was independent predictor of OS (HR = 7.01; 95% CI 3.09-15.88; P < .001). Patients with LDH level >435 U/L at the baseline had significantly shorter PFS and OS compared to patients with LDH level ≤435 U/L (median PFS: 1.7 vs 3.5 months, P = .040; median OS: 3.7 vs 18.5 months, P < .001). Patients with non-durable clinical benefit (NDB) had significantly higher LDH level at the baseline compared to patients who achieved durable clinical benefit (DCB) (P = .025). Post-treatment levels of CRP, LDH, and NLR were decreased compared to baseline in patients with DCB (P = .030, P = .088, and P = .066, respectively), whereas, there was a significant increase in post-treatment level of LDH compared with baseline in patients with NDB (P = .024).

Conclusions: LDH level at the baseline was an independent predictor of OS and pretreatment metastases numbers was a significant predictor of PFS and OS.

Keywords: clinical biomarkers; immune checkpoint inhibitors; lactate dehydrogenase; nasopharyngeal carcinoma; peripheral blood.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Baseline LDH, CRP, NLR levels and treatment response. Abbreviations: LDH, lactate dehydrogenase; CRP, C-reactive protein; NLR, neutrophil to lymphocyte ratio; SD, stable disease; PR, partial response; PD, progressed disease; DCB, durable clinical benefit; NDB, non-durable clinical benefit.
Figure 2.
Figure 2.
Baseline LDH, CRP, NLR levels and clinical benefit. Abbreviations: LDH, lactate dehydrogenase; CRP, C-reactive protein; NLR, neutrophil to lymphocyte ratio; SD, stable disease; PR, partial response; PD, progressed disease; DCB, durable clinical benefit; NDB, non-durable clinical benefit.
Figure 3.
Figure 3.
Post-treatment changes of CRP, LDH and NLR compared with baseline in patients with durable response. Abbreviations: CRP, C-reactive proteins; LDH, lactate dehydrogenase; NLR, neutrophil to lymphocyte ratio.
Figure 4.
Figure 4.
Post-treatment changes of CRP, LDH and NLR compared with baseline in patients with non-durable response. Abbreviations: CRP, C-reactive proteins; LDH, lactate dehydrogenase; NLR, neutrophil to lymphocyte ratio.
Figure 5.
Figure 5.
Kaplan Meier estimates of progression-free survival (PFS) according to the mean value of baseline CRP, LDH and NLR.
Figure 6.
Figure 6.
Kaplan Meier estimates of overall survival (OS) according to the mean value of baseline CRP, LDH and NLR.
See this image and copyright information in PMC

References

    1. Chen YP, Chan ATC, Le QT, Blanchard P, Sun Y, Ma J. Nasopharyngeal carcinoma. Lancet. 2019;394:64-80. - PubMed
    1. Zhang L, Huang Y, Hong S, et al. Gemcitabine plus cisplatin versus fluorouracil plus cisplatin in recurrent or metastatic nasopharyngeal carcinoma: A multicentre, randomised, open-label, phase 3 trial. Lancet. 2016;388:1883-1892. - PubMed
    1. Lv X, Cao X, Xia WX, et al. Induction chemotherapy with lobaplatin and fluorouracil versus cisplatin and fluorouracil followed by chemoradiotherapy in patients with stage III-IVB nasopharyngeal carcinoma: an open-label, non-inferiority, randomised, controlled, phase 3 trial. Lancet Oncol. 2021;22:716-726. - PubMed
    1. Ou SI, Zell JA, Ziogas A, Anton-Culver H. Epidemiology of nasopharyngeal carcinoma in the United States: improved survival of Chinese patients within the keratinizing squamous cell carcinoma histology. Ann Oncol. 2007;18:29–35. - PubMed
    1. Zhang J, Fang W, Qin T, et al. Co-expression of PD-1 and PD-L1 predicts poor outcome in nasopharyngeal carcinoma. Med Oncol. 2015;32:86. - PubMed

Substances