In a nutshell
This study investigated whether levels of S100B and lactate dehydrogenase (LDH) in patients with melanoma treated with immunotherapy has any relationship to survival. The study found that increased levels of S100B and LDH were associated with reduced survival in patients with melanoma treated with certain immunotherapies.
Immunotherapies such as anti-PD-1 and anti-CTLA-4 are used to target and kill cancer cells in patients with melanoma. However, some patients do not respond to these treatments.
Levels of SB-100 (a protein) are used to determine if a patient has melanoma. Levels of lactate dehydrogenase (LDH) in the blood are used to determine if melanoma has spread to other parts of the body (metastasized).
It is important to understand if levels of SB-100 and LDH can be used to determine if patients will respond to immunotherapy such as anti-PD-1 and anti-CTLA-4 in order to help guide choice of treatment for patients with melanoma.
Methods & findings
This study analysed data previously collected from 238 patients with stage III or stage IV melanoma who were treated with the anti- PD-1 therapy pembrolizumab (Keytruda) (group 1) or with the anti- CTLA-4 therapy ipilimumab (Yervoy) in combination with the anti-PD1 therapy nivolumab (Opdivo) (group 2).
In both groups, levels of LDH and S100B in the blood were measured before treatment. Response to treatment was recorded in all patients.
In group 1 (patients treated with pembrolizumab), 51.1% of patients with increased levels of S100B before treatment were alive 1 year later (overall survival). 83.1% of patients with normal S100B levels before treatment were alive 1 year later.
44.4% of patients in group 1 who had increased levels of LDH before treatment were alive 1 year later, compared with 80.8 % of patients with normal LDH levels before treatment.
In group 2 (patients treated with ipilimumab and nivolumab), baseline S100B and increasing S100B levels of >145% as well as baseline LDH were associated with reduced overall survival, whereas increasing LDH of >25% was not asssociatd with reduced survival.
The bottom line
The study showed that patients with melanoma whom have increased levels of LDH and S100B experience decreased survival compared with those patients with lower levels of LDH and S100B when treated with the anti-PD-1 therapy pembrolizumab.
The fine print
This study analysed data previously collected which can affect the results. This data was collected from one hospital so the results may not reflect results at other hospitals.
Speak to your doctor about analysis of LDH and SB100 levels and how this might influence choice of treatment.
Published By :
British Journal of Cancer
Jun 28, 2018