Association between D-dimer and the long-term prognosis of advanced cancer patients receiving PD-1/PD-L1 inhibitors: A meta-analysis

doi:10.3969/j.issn.1004-583X.2025.02.001

Abstract

Abstract:

Objective The study aims to analyze the associations between pretreatment D-dimer (D-D) levels and the long-term prognosis of advanced cancer patients receiving programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) inhibitors. Methods Relevant literatures published up to October 20, 2024, were retrieved from databases including China National Knowledge Infrastructure (CNKI), Wanfang, VIP, Pubmed, Web of Science, and Cochrane Library. Six literatures were ultimately included in the analysis. Results The advanced cancer patients receiving PD-1/PD-L1 inhibitors with high D-D levels had significantly shorter progression free survival (PFS) (univariate analysis: HR=1.89, 95%CI: 1.33-2.67, P=0.0004; multivariate analysis: HR=1.79, 95%CI: 1.18-2.72, P=0.006) and overall survival (OS) (univariate analysis: HR=2.02, 95%CI: 1.60-2.56, P<0.00001; multivariate analysis: HR=2.08, 95%CI: 1.63-2.65, P<0.00001) than those with normal D-D levels. Conclusion D-D may serve as a potential biomarker for predicting the prognosis of advanced cancer patients receiving PD-1/PD-L1 inhibitors.

Key words: D-dimer, immunotherapy, prognosis, biomarker

CLC Number:

R730.51

Ye Qian, Liu Shenxiang. Association between D-dimer and the long-term prognosis of advanced cancer patients receiving PD-1/PD-L1 inhibitors: A meta-analysis[J]. Clinical Focus, 2025, 40(2): 101-106.

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https://lchc.magtechjournal.com/EN/Y2025/V40/I2/101

Figures/Tables 6

References 22

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第一作者	发表年份	研究类型	肿瘤类型			患者数量	年龄(岁, 中位数,范围)		PD-1/PD-L1 抑制剂类型		D-二聚体检测时间
Wei等^[9]	2021	回顾性	晚期NSCLC			64	-		帕博利珠单抗		治疗前、最佳缓解期、疾病进展期
Zhang等^[10]	2022	回顾性	晚期MSS/pM MR CRC			110	53(22-81)		信迪利单抗、卡瑞利珠单抗、特瑞普利单抗、替雷利珠单抗、帕博利珠单抗		治疗前
Li等^[11]	2022	回顾性	晚期NSCLC			277	61(33-91)		-		治疗前
Chen等^[12]	2023	回顾性	晚期或复发 NSCLC			100	D-二聚体<0.98 mg/L:63(57-68);E-D-二聚体≥0.98 mg/L:64(54.5-68)		纳武利尤单抗、信迪利单抗、卡瑞利珠单抗、帕博利珠单抗		治疗前
Sun等^[13]	2024	回顾性	晚期NSCLC			80	63(34-73)		信迪利单抗、卡瑞利珠单抗、特瑞普利单抗		治疗前、最佳缓解期、疾病进展期
Wu等^[14]	2024	回顾性	晚期或转移性ESCC			233	-		-		治疗前
第一作者	D-二聚体截断值(mg/L)			生存结局	单因素分析(HR,95%CI)					多因素分析(HR,95%CI)
第一作者	D-二聚体截断值(mg/L)			生存结局	OS			PFS		OS		PFS
Wei等^[9]	1.51			PFS	-			-		-		1.72(0.59~5.00)
Zhang等^[10]	0.30			PFS	-			1.71(1.09~2.70)		-		1.28(0.80~2.04)
Li等^[11]	0.50			OS、PFS	2.29(1.52~3.46)			1.80(1.30~2.49)		2.13(1.40~3.25)		1.84(1.32~2.56)
Chen等^[12]	0.98			PFS	-			7.37(2.53~21.51)		-		14.09(3.26~60.84)
Sun等^[13]	-			OS	1.00(1.00~1.00)			-		-		-
Wu等^[14]	0.24			OS、PFS	1.90(1.42~2.53)			1.51(1.15~1.98)		2.05(1.52~2.76)		1.52(1.15~2.03)

第一作者	发表年份	研究类型	肿瘤类型			患者数量	年龄(岁, 中位数,范围)		PD-1/PD-L1 抑制剂类型		D-二聚体检测时间
Wei等^[9]	2021	回顾性	晚期NSCLC			64	-		帕博利珠单抗		治疗前、最佳缓解期、疾病进展期
Zhang等^[10]	2022	回顾性	晚期MSS/pM MR CRC			110	53(22-81)		信迪利单抗、卡瑞利珠单抗、特瑞普利单抗、替雷利珠单抗、帕博利珠单抗		治疗前
Li等^[11]	2022	回顾性	晚期NSCLC			277	61(33-91)		-		治疗前
Chen等^[12]	2023	回顾性	晚期或复发 NSCLC			100	D-二聚体<0.98 mg/L:63(57-68);E-D-二聚体≥0.98 mg/L:64(54.5-68)		纳武利尤单抗、信迪利单抗、卡瑞利珠单抗、帕博利珠单抗		治疗前
Sun等^[13]	2024	回顾性	晚期NSCLC			80	63(34-73)		信迪利单抗、卡瑞利珠单抗、特瑞普利单抗		治疗前、最佳缓解期、疾病进展期
Wu等^[14]	2024	回顾性	晚期或转移性ESCC			233	-		-		治疗前
第一作者	D-二聚体截断值(mg/L)			生存结局	单因素分析(HR,95%CI)					多因素分析(HR,95%CI)
第一作者	D-二聚体截断值(mg/L)			生存结局	OS			PFS		OS		PFS
Wei等^[9]	1.51			PFS	-			-		-		1.72(0.59~5.00)
Zhang等^[10]	0.30			PFS	-			1.71(1.09~2.70)		-		1.28(0.80~2.04)
Li等^[11]	0.50			OS、PFS	2.29(1.52~3.46)			1.80(1.30~2.49)		2.13(1.40~3.25)		1.84(1.32~2.56)
Chen等^[12]	0.98			PFS	-			7.37(2.53~21.51)		-		14.09(3.26~60.84)
Sun等^[13]	-			OS	1.00(1.00~1.00)			-		-		-
Wu等^[14]	0.24			OS、PFS	1.90(1.42~2.53)			1.51(1.15~1.98)		2.05(1.52~2.76)		1.52(1.15~2.03)

亚组	单因素分析			亚组	多因素分析
亚组	文献数量	HR(95%CI)	P	亚组	文献数量	HR(95%CI)	P
肿瘤类型				肿瘤类型
NSCLC	2	3.31(0.84~13.00)	0.09	NSCLC	2	4.47(0.62~32.34)	0.14
CRC	1	1.71(1.08~2.70)	0.02	CRC	1	1.28(0.80~2.03)	0.30
ESCC	1	1.51(1.15~1.98)	0.003	ESCC	1	1.52(1.14~2.03)	0.004
D-二聚体截断值(mg/L)				D-二聚体截断值(mg/L)
<0.5	2	1.56(1.23~1.97)	0.0002	<0.5	2	1.45(1.14~1.85)	0.003
≥0.5	2	3.31(0.84~13.00)	0.09	≥0.5	2	4.47(0.62~32.34)	0.14

亚组	单因素分析			亚组	多因素分析
亚组	文献数量	HR(95%CI)	P	亚组	文献数量	HR(95%CI)	P
肿瘤类型				肿瘤类型
NSCLC	2	3.31(0.84~13.00)	0.09	NSCLC	2	4.47(0.62~32.34)	0.14
CRC	1	1.71(1.08~2.70)	0.02	CRC	1	1.28(0.80~2.03)	0.30
ESCC	1	1.51(1.15~1.98)	0.003	ESCC	1	1.52(1.14~2.03)	0.004
D-二聚体截断值(mg/L)				D-二聚体截断值(mg/L)
<0.5	2	1.56(1.23~1.97)	0.0002	<0.5	2	1.45(1.14~1.85)	0.003
≥0.5	2	3.31(0.84~13.00)	0.09	≥0.5	2	4.47(0.62~32.34)	0.14