ArticleFrontiers in oncology2025
Prognostic value of LDH and α-HBDH dynamic levels for 1-year overall survival and progression-free survival in patients with extensive-stage small-cell lung cancer treated with chemoimmunotherapy.
Article in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- The risk factors and predictive nomogram for postoperative hypoalbuminemia in elderly patients undergoing hip arthroplasty.Frontiers in nutrition · 2026Article
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Abstract
Background: Extensive-stage small cell lung cancer (ES-SCLC) remains a lethal malignancy with limited prognostic biomarkers. This study evaluated the prognostic utility of lactate dehydrogenase (LDH) and α-hydroxybutyrate dehydrogenase (α-HBDH) levels at baseline and after 2 cycles of treatment in ES-SCLC patients receiving first-line chemoimmunotherapy. Methods: Continuous variables were converted into categorical ones based on optimal cutoffs identified by ROC curve analysis (maximizing Youden's index). Overall survival (OS) and progression-free survival (PFS) were calculated via the Kaplan-Meier method and compared via the log-rank test. In addition, the Cox regression model was used to analyze prognostic factors. Associations between LDH and α-HBDH levels and clinical parameters (T/N stage, age, and immune-related toxicity) were analyzed using the Mann-Whitney U test and binary logistic regression. Results: A cohort of 201 ES-SCLC patients treated with chemotherapy and immune checkpoint inhibitors was analyzed retrospectively. Elevated baseline serum LDH >245 U/L and α-HBDH >182 U/L levels predicted poor OS (p = 0.046, HR = 1.798, 95% CI: 1.020-3.167; p = 0.007, HR = 2.268, 95% CI: 1.288-3.994); inadequate 2-cycle reductions (ΔLDH ≤ 108.5U/L; Δα-HBDH ≤ 62.5U/L) further predicted poor OS (p<0.001, HR = 2.561, 95% CI: 1.291-5.080; p<0.001, HR = 2.807, 95% CI: 1.457-5.411). For progression-free survival, no significant difference was observed between patients with elevated baseline serum LDH >245 U/L or α-HBDH >182 U/L and those with normal levels; similarly, there was no significant difference between patients with an on-treatment increase (ΔLDH>12.5 U/L or Δα-HBDH>0.5 U/L from baseline) and those with a lesser increase or decrease. (P = 0.768, HR = 1.055, 95% CI: 0.739-1.507 for baseline LDH; P = 0.529, HR = 1.121, 95% CI: 0.785-1.601 for baseline α-HBDH; P = 0.115, HR = 0.719, 95% CI: 0.457-1.131 for ΔLDH; P = 0.094, HR = 0.730, 95% CI: 0.494-1.080 for Δα-HBDH). Advanced T4/N3 stage and age ≥65 years significantly modulated biomarker trajectories (p<0.05). Conclusion: LDH and α-HBDH serve as key prognostic biomarkers in ES-SCLC patients undergoing first-line chemoimmunotherapy. We established clinically validated thresholds, which can guide treatment by identifying patients with elevated or insufficiently declining levels as high-risk, thereby supporting early and targeted therapeutic intervention.
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