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Baseline LDH and SII levels emerged as key predictors of survival outcomes in individuals with advanced melanoma receiving first-line anti-PD-1 therapy.   

Researchers conducted a retrospective study published in June 2025 issue of International Journal of Dermatology to identify potential biomarkers associated with objective response (ORR), progression-free survival (PFS), and overall survival (OS) in individuals receiving first-line anti–PD-1 immunotherapy for advanced melanoma.  

They assessed 138 individuals with advanced melanoma who received first-line anti–PD-1 monoclonal antibodies. Baseline blood markers were evaluated as possible predictive or prognostic indicators. The ORR was determined using both RECIST v.1.1 (Response Evaluation Criteria in Solid Tumors) and iRECIST (Immune Response Evaluation Criteria in Solid Tumors). The PFS and OS were analyzed using Kaplan–Meier survival curves. Group comparisons were made with the log-rank test. A multivariate Cox regression model identified independent survival predictors, while logistic regression was applied to evaluate treatment response.  

The results showed that the median follow-up was 44.1 months (95% CI: 40.4–49.4]). Elevated pretreatment lactate dehydrogenase (LDH) and systemic immune-inflammation index (SII) were associated with worse PFS, though only LDH remained significant in multivariate analysis ([hazard ratio (HR) 1.72, 95% CI: 1.09–2.70, P = 0.019]; SII: [HR 1.69, 95% CI: 0.95–3.00, P= 0.072]). Both elevated LDH and SII were independently linked to reduced OS on multivariate analysis ([HR 2.25, 95% CI: 1.35–3.75, P= 0.002] and [HR 2.37, 95% CI: 1.29–4.37, P= 0.006], respectively).  

Investigators concluded that elevated pretreatment levels of SII and LDH independently predicted poorer OS, and their integration into a nomogram enabled estimation of 24-month OS in individuals receiving first-line anti-PD-1 therapy. 

Source: onlinelibrary.wiley.com/doi/10.1111/ijd.17842