Author Identifier (ORCID)
Elin Gray: https://orcid.org/0000-0002-8613-3570
Abstract
Introduction: Metastatic melanoma carries a poor prognosis. Immune checkpoint inhibitors (ICIs) have improved outcomes, but responses remain variable, highlighting the need for simple prognostic biomarkers. Inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lactate dehydrogenase (LDH) reflect tumour burden and inflammation, though their clinical utility is unstandardised. Methods: We retrospectively analysed 103 metastatic melanoma patients treated with anti-PD-1 monotherapy at two centres in Western Australia (2014–2020). Baseline NLR, PLR, and LDH were assessed within 30 days pre-treatment. Outcomes included clinical benefit, progression-free survival (PFS), and overall survival (OS). Results: Poor ECOG performance status (PS ≥2) (RR 2.39, 95% CI 1.48–3.86) and elevated LDH (≥250 U/L) (RR 1.68, 95% CI 1.21–2.31) were associated with no clinical benefit (p < 0.001). NLR ≥5 predicted significantly worse OS (9.1 vs 28.2 months; HR 8.54, 95% CI 2.58–28.32; p < 0.001). Elevated LDH predicted shorter OS (6.0 vs 50.3 months; HR 3.68, 95% CI 1.65–8.21; p = 0.002) and PFS (19.0 months vs not reached; HR 2.51, 95% CI 1.37–4.72; p = 0.004). Conclusion: ECOG PS ≥2 and elevated NLR were associated with no clinical benefit, while elevated NLR and LDH independently predicted poorer survival. These markers may serve as practical prognostic tools in metastatic melanoma treated with ICIs.
Document Type
Journal Article
Date of Publication
1-1-2025
PubMed ID
41230650
Publication Title
Cancer Investigation
Publisher
Taylor & Francis
School
Centre for Precision Health / School of Medical and Health Sciences
RAS ID
84627
Funders
The University of Oxford
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Comments
Wijaya, W., Khattak, M. A., Abed, A., Meniawy, T., Millward, M., Gray, E., & Oey, O. (2025). Prognostic value of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lactate dehydrogenase level in melanoma patients treated with immune checkpoint inhibitors. Cancer Investigation, 43(10), 945–957. https://doi.org/10.1080/07357907.2025.2586257