Prognostic Value of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Lactate Dehydrogenase Level in Melanoma Patients Treated with Immune Checkpoint Inhibitors.

IntroductionMetastatic 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.MethodsWe 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).ResultsPoor 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