Changes in serum lactate dehydrogenase as a prognostic factor in patients with head and neck squamous cell carcinoma treated with immune checkpoint inhibitors

Abstract

Background

Lactate dehydrogenase (LDH) is involved in the Warburg effect. Elevated serum LDH is a prognostic marker for metastatic solid cancer.

Aim

To investigate the prognostic impact of serum LDH in patients with head and neck squamous cell carcinoma treated with immune checkpoint inhibitors (ICIs).

Materials and Methods

This retrospective study included 129 patients treated with ICIs between 2017 and 2023. The effects of pretreatment LDH, LDH at 3 months, and change in LDH during the first 3 months (ΔLDH) on overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan–Meier method and Cox regression model.

Results

The 1-year PFS and OS rates for high and low groups were 6.0% and 30.1% for pretreatment LDH (p = 0.044), 25.7% and 38.3% for on-treatment LDH (p = 0.079), and 14.3% and 38.7% for ΔLDH (p = 0.008), as well as 42.1% and 60.9% for pretreatment LDH (p = 0.109), 56.0% and 80.5% (p < 0.001) for on-treatment LDH, and 31.0% and 81.0% for ΔLDH (p < 0.001), respectively. ΔLDH was an independent prognostic factor for both PFS and OS.

Conclusions and Significance

ΔLDH can be used to predict ICI treatment outcomes and as a marker in deciding to continue ICI therapy.

Chinese Abstract

背景

乳酸脱氢酶 (LDH) 参与瓦博格效应。血清 LDH 升高是转移性实体癌的预后标志。

目的

研究血清 LDH 对接受免疫检查点抑制剂 (ICI) 治疗的头颈部鳞状细胞癌患者的预后影响。

材料和方法

这项回顾性研究包括 了2017 年至 2023 年期间接受 ICI 治疗的 129 名患者。使用 Kaplan-Meier 方法和 Cox 回归模型分析了治疗前 LDH、3 个月时的 LDH 和前 3 个月内 LDH 的变化 (ΔLDH) 对总生存期 (OS) 和无进展生存期 (PFS) 的影响。

结果

低组的 1 年 PFS率 和 OS 率分别为治疗前 LDH 6.0% 和 30.1%(p = 0.044)、治疗中 LDH 25.7% 和 38.3%(p = 0.079)和 ΔLDH 14.3% 和 38.7%(p = 0.008)； 高组的 1 年 PFS率 和 OS 率分别治疗前 LDH 42.1% 和 60.9%(p = 0.109)、治疗中 LDH 56.0% 和 80.5%(p < 0.001), ΔLDH 31.0% 和 81.0%(p < 0.001)。ΔLDH 是 PFS 和 OS 的独立预后因素。

结论和意义

ΔLDH可用于预测ICI治疗结果, 并作为决定是否继续ICI治疗的标志。

Keywords:

• Lactate dehydrogenase
• prognostic marker
• immune checkpoint inhibitors
• metastatic solid cancer
• head and neck squamous cell carcinoma

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This work was supported by JSPS KAKENHI Grant Number JP24K12647.