LDH, MLR linked to prognosis in older patients with mCRC

High lactate dehydrogenase (LDH) and monocyte-to-lymphocyte ratio (MLR) levels in the sera of older patients with metastatic colorectal cancer (mCRC) signal unfavourable disease prognosis, a recent study has found.

The researchers conducted a retrospective investigation of 168 older mCRC patients (age >70 years; 58.92 percent male). Baseline variables collected included: demographic factors, site of primary tumour, first-line therapy received, and lab results, including LDH and monocyte and lymphocyte counts. Overall survival (OS) was set as a primary outcome.

High LDH (>480 U/L) and MLR (>0.45) were reported in 22 percent (n=22) and 32 percent (n=53) of the participants, respectively, prior to first-line chemotherapy. Median OS was 19.2 months, calculated after a median follow-up of 51.5 months.

Multivariate Cox regression analysis revealed that a high level of baseline LDH independently and significantly doubled the risk of worse OS (hazard ratio [HR], 2.00, 95 percent confidence interval [CI], 1.13–3.55; p=0.017), while high MLR nearly tripled this risk (HR, 2.99, 95 percent CI, 1.68–5.33; p<0.001).

In addition, peritoneal (HR, 2.63, 95 percent CI, 1.44–4.81; p=0.002) and bone (HR, 4.84, 95 percent CI, 1.73–13.53; p=0.003) metastases were also significant indicators of worse prognosis.

“[A]geing induces meaningful changes in inflammation and immune-suppressive biomarkers response with a consequent increase in MLR and LDH levels,” the researchers said. “In the present study, high baseline levels of LDH, MLR, or both were unfavourable independent prognostic factors in older patients treated with first-line chemotherapy for mCRC.”

“These preliminary results emphasize the need for prospective studies aimed at validating these potentially cost-effective biomarkers, especially in older patients,” they added.